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Pre Certification Coordinator buy in US, Free Classifieds Ads

Kforce has a client in search of a Preferred Skills: Certification Coordinator in Charlestown, Massachusetts (MA). Essential Job Functions:
Work collaboratively and confidentially with support staff as well as other hospital departments, insurance carriers/authorizing agencies to obtain required pre-certification/approval for scheduled procedures
Work collaboratively with health insurance carriers to verify/confirm eligibility
Establish a contact network with the plans/agencies that will enable the pre-certification process to work quickly and efficiently
Record all information related to approvals and denials including but not limited to the approval number, the date of the approval and name of the contact that are communicated to the provider in EPIC
Communicate all pre-certification and/or authorization denials with MEE Financial Counselors and clinical areas
Work closely with the physicians and their support staff to obtain the detailed information required to pre-certify a service; This includes obtaining complete registration, insurance, and the clinical data necessary for completing the pre-certification/authorization process
Collaborate with support staff in situations where insurance carriers require additional clinical information such as peer to peer requests
Work with Primary Care Physicians offices to obtain appropriate referrals and authorizations; Confirm this information with insurance carrier prior to the scheduled date
Maintain strict confidentiality regarding all patient matters; Secure confidential information through the workday
Minimum of three years of experience in a health care setting
Previous experience with pre-certification/approval processes and knowledge on managed care and other health insurance policies helpful
Current knowledge of CPT/ICD-10-CM coding preferred
Must possess the ability to communicate and deal effectively with patients, physicians, visitors, and peers in the course of performing job responsibilities
Kforce is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status. Compensation Type: Hours Minimum Compensation: 0.00 Maximum Compensation: 0.00

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