Pre-Certification Representative-Central Scheduling
Summary Position Summary This position serves as a primary contact for Pre-Certification activities.
Handling of patients accounts includes registration, medical necessity and prior authorization activities.
Incumbent must possess a high level of working knowledge regarding insurance carrier requirements.
Position is responsible for confirming patients insurance coverage, eligibilitity, collect benefits information and perform prior authorization for Outpatient services They must have exceptional verbal and written communication skills with a strong attention to detail; proven organizational skills required.
They must conduct all interactions with patient, physician offices and other personel in a courteous, respectful manner while maintaining confidentiality.
All tasks are required to be done per established protocols and accuracy standards while demonstrating the SMHC mission to improve the health and healthcare of the communities we serve.
To be successful in this role, the employee must be competent, flexible and adaptive to changes in healthcare delivery and technology.
Required Minimum Knowledge, Skills, and Abilities (KSAs) Education:
High School graduate or GED preferred.
License/Certifications:
N/A
Experience:
Experience with an electronic medical record system preferred.
Advanced experience with emailing, keyboarding/typing and voice-mail systems required.
Demonstrated knowledge of medical terminology required.
Demonstrated knowledge of insurance websites and ability to ascertain eligibility, authorizations and benefit details.
Demonstrated knowledge of medical insurance and their respective billing requirements (IE:
Worker's Compensation, Third PartyLiabilities, Medicare, Maine Care, and all commercial insurances) Understanding of diagnostic and procedure coding systems IE:
ICD-10-CM and CPT Codes/HCPS codes required.
Understanding the insurance precertification process required.
Strong interpersonal and telephone soft skills required.
Previous success in positions requiring minimal supervision and strong personal initiative is desirable.
Ability to work in a fast paced environment Additional Information With a career at any of the MaineHealth locations across Maine and New Hampshire, you'll be working with health care professionals that truly value the people around them - both within the walls of the organization and the communities that surround it.
We offer benefits that support an individual's needs for today and flexibility to plan for tomorrow - programs such as paid parental leave, a flexible work policy, student loan assistance, training and education, along with well-being resources for you and your family.
MaineHealth remains focused on investing in our care team and developing an inclusive environment where you can thrive and feel supported to realize your full potential.
If you're looking to build a career in a place where people help one another deliver best-in-class care, apply today.
Additional Information MaineHealth is a health system whose members and affiliates include hospitals, physician practices, long-term care facilities, home care agencies, and support services.
Learn more about this system at www.
mainehealth.
org Recommended Skills Attention To Detail Billing Cpt Coding Communication Confidentiality Coordinating Estimated Salary: $20 to $28 per hour based on qualifications.
Handling of patients accounts includes registration, medical necessity and prior authorization activities.
Incumbent must possess a high level of working knowledge regarding insurance carrier requirements.
Position is responsible for confirming patients insurance coverage, eligibilitity, collect benefits information and perform prior authorization for Outpatient services They must have exceptional verbal and written communication skills with a strong attention to detail; proven organizational skills required.
They must conduct all interactions with patient, physician offices and other personel in a courteous, respectful manner while maintaining confidentiality.
All tasks are required to be done per established protocols and accuracy standards while demonstrating the SMHC mission to improve the health and healthcare of the communities we serve.
To be successful in this role, the employee must be competent, flexible and adaptive to changes in healthcare delivery and technology.
Required Minimum Knowledge, Skills, and Abilities (KSAs) Education:
High School graduate or GED preferred.
License/Certifications:
N/A
Experience:
Experience with an electronic medical record system preferred.
Advanced experience with emailing, keyboarding/typing and voice-mail systems required.
Demonstrated knowledge of medical terminology required.
Demonstrated knowledge of insurance websites and ability to ascertain eligibility, authorizations and benefit details.
Demonstrated knowledge of medical insurance and their respective billing requirements (IE:
Worker's Compensation, Third PartyLiabilities, Medicare, Maine Care, and all commercial insurances) Understanding of diagnostic and procedure coding systems IE:
ICD-10-CM and CPT Codes/HCPS codes required.
Understanding the insurance precertification process required.
Strong interpersonal and telephone soft skills required.
Previous success in positions requiring minimal supervision and strong personal initiative is desirable.
Ability to work in a fast paced environment Additional Information With a career at any of the MaineHealth locations across Maine and New Hampshire, you'll be working with health care professionals that truly value the people around them - both within the walls of the organization and the communities that surround it.
We offer benefits that support an individual's needs for today and flexibility to plan for tomorrow - programs such as paid parental leave, a flexible work policy, student loan assistance, training and education, along with well-being resources for you and your family.
MaineHealth remains focused on investing in our care team and developing an inclusive environment where you can thrive and feel supported to realize your full potential.
If you're looking to build a career in a place where people help one another deliver best-in-class care, apply today.
Additional Information MaineHealth is a health system whose members and affiliates include hospitals, physician practices, long-term care facilities, home care agencies, and support services.
Learn more about this system at www.
mainehealth.
org Recommended Skills Attention To Detail Billing Cpt Coding Communication Confidentiality Coordinating Estimated Salary: $20 to $28 per hour based on qualifications.
|
|
 | |
