TriHealth Precertification Specialist
Start Date: As soon as possible
Job Type: Contract to Hire
Interview: Phone screen then on-site
Location: Norwood, OH
Our client's Pre-Certification team is looking to bring on a Pre-certification Specialist. They are looking for candidates with General Surgery and Infusion background. If that isnt available in the area Radiology experience (MRI, CT Scans) but would also be acceptable with a Precertification background.
This would be an on-site 40 hour per week job. They will be working out of the Norwood, OH location.
This position is responsible for obtaining pre-certifications and authorizations by reviewing and submitting Patients' clinical information to Payers. Other job duties include entering patient information into the electronic medical record (Epic), recording insurance information, frequent telephone contact with patients, and performs other duties as required.
- Responsible for obtaining and communicating pre-certifications as needed per insurance company requirements.
- Responsible for tracking, obtaining, and extending authorizations from various carries in a timely manner.
- Verify receipt of all necessary pre-authorization documents prior to the procedure.
- Experience actually reviewing Patients' Clinical Notes and submitting to Payers
- Knowledge of medical terminology
- Experience wanted in Surgury and Infusion. Radiology and Oncology are also acceptable.
- Epic EMR
- Familiarity with different insurance websites and portals
- 3-5 years of pre-certification or pre-authorization experience preferred.
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