UofL Physicians

Precertification Specialist

US-KY-Louisville
Job ID
2017-3856
# of Openings
1
Category
Front Office

Overview

JOB SUMMARY

Responsible for benefit verification and obtaining precertification’s/authorizations for services provided to patients.  Works collaboratively with physicians and staff to ensure all precertification requirements are reviewed and completed prior to the date of service.

Responsibilities

  • Review, evaluate verify and process assigned clinic pre-certification requests for Inpatient, Outpatient and Clinic procedures.
  • Enter all pre-certification information into the scheduling and billing system.
  • Contact insurance companies for pre-certification, at least seven days prior to the patient's scheduled procedure.
  • Assist Clinics in obtaining pre-certification for emergency admits and for patients needing same day clinic visit/hospital admit/procedure.
  • Verify patient eligibility and pre-certification requirements through On-line verification software or by telephone.
  • Maintain open line of communication with clinic personnel.
  • Assists in training new employees of the Pre-certification team.
  • Provide Team Coverage.
  • Performs other tasks as assigned by supervisor.

Qualifications

MINIMUM EDUCATION & EXPERIENCE

  • High school diploma or GED required, college preparation preferred.
  • 2-5 years’ experience in a healthcare precertification role, preferred.

KNOWLEDGE, SKILLS, & ABILITIES

  • Thorough knowledge of the healthcare revenue cycle including ICD-9 and CPT coding, and CMS guidelines
  • Working knowledge of electronic health records and practice management systems
  • Knowledge of current payer precertification processes and guidelines
  • Ability to multi-task and function effectively in a dynamic and fast-paced environment

WORKING CONDITIONS

Normal for a health care environment

JOB REQUIREMENTS

  • Candidates upon hire will complete an electronic I-9 verification.
  • Only those candidates whose experience best meets our requirements will be contacted.
  • University of Louisville Physicians is an Equal Opportunity Employer.
  • Current UofL Physicians employees must follow the UofL Physicians Internal Transfer Policy.

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