Pre Cert Representative

Position Overview

The Pre-Certification Representative obtains all pertinent insurance benefit information and/or pre-certification information for patients before scheduled for clinical services. The position requires excellent customer service for concise and articulate communication with insurance companies, scheduling personnel, physicians’ offices and patients.

Essential Job Duties

• Handles precertification procedures pertaining to patients by collecting insurance information and entering information into Prime Suite system.
• Verifies insurance benefits/coverage by contacting insurance companies; obtains insurance information for precertification for procedure; works with insurance company, health care provider & patient to get claims processed & paid.
• Answers patient inquiries in a professional & courteous manner.
• Records benefit and certification information into the applicable computer system and communicates with scheduling in accordance to established work processes.
• Performs other duties as assigned.

Education

• High School Diploma or equivalent required.
• 1 – 2 years’ experience in medical or related field

Additional Requirements

• Knowledge of medical terminology and procedures, knowledge of health insurance industry practices and/or medical billing procedures.
• Experience with medical scheduling/billing systems preferred.
• Exceptional customer service, interpersonal skills, and communication skills
• Proficiency of electronic records systems preferred. Must have strong data entry skills.
• Must be able to complete tasks with a high-degree of efficiency and accuracy while working in a fast-paced environment with frequent disruptions.
• Must demonstrate ability to analyze data and resolve complex problems.
• Must have the ability to work independently while managing time and workload appropriately.
• Must be able to travel to all clinic locations and work overtime hours as needed.

Job Type: Full-time

Remote: None