Pre-certification Specialist - Reidsville, GA at Optim

Reidsville, Georgia, United States -

Full Time

Start Date

Immediate

Expiry Date

17 Jul, 26

Salary

0.0

Posted On

18 Apr, 26

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Medical terminology, Insurance industry knowledge, ICD-9 coding, CPT coding, Data entry, Medical records management, Patient communication, Computer literacy, Office equipment operation, Confidentiality, Filing systems, Grammar and punctuation

Industry

Medical Practices

Description

OPTIM MEDICAL CENTER TATTNALL is seeking a full time Physical Therapy Pre-certification Specialist JOB TITLE: Pre-certification Specialist GENERAL SUMMARY OF DUTIES: Pre-certs all therapy services prior to day of therapy and follows up with insurance companies if diagnosis or procedures changed. Must be familiar with ICD-9 and CPT code books. SUPERVISION RECEIVED: Reports directly to the Director of Patient Access SUPERVISION EXERCISED: None TYPICAL PHYSICAL DEMANDS: Work may require sitting for long periods of time; also stooping, bending and stretching for files and supplies. Occasionally lifting files or paper weighing up to 30 pounds. Requires manual dexterity sufficient to operate a keyboard, type, operate a calculator, telephone, copier and other such office equipment as necessary. Vision must be correctable to 20/20 and hearing must be in the normal range for telephone contacts. It is necessary to view and type on computer screens for long periods and to work in an environment which can be very stressful. TYPICAL WORKING CONDITIONS: Work is performed in an office environment. Involves frequent contact with staff, patients, insurance company representatives and the public. Work may be stressful at times. Contact may involve dealing with angry or upset people. DUTIES: (This list may not include all of the duties assigned). 1. Reviews patients’ medical records 2. Works with medical and other staff in coordinating medical information and patient charts 3. Responsible for pre-certing all therapaies, if required by ICD-9 code with the appropriate insurance company 4. Follows-up with insurance companies ensuring that coverage is in effect 5. Documents all actions and maintains permanent record in patients’ chart 6. Answers patient questions and inquiries regarding the precert status of their therapy 7. Maintains strict confidentiality of sensitive information 8. Performs related work as required PERFORMANCE REQUIREMENTS: Knowledge, Skills & Abilities: Knowledge of medical terminology. Knowledge of grammar, spelling, and punctuation to type correspondence. Knowledge of insurance industry. Skill in operating a computer and photocopy machine. Ability to read, understand, and follow oral and written instruction. Ability to maintain confidentiality of sensitive information. Ability to sort and file materials correctly by alphabetic or numeric systems. Ability to speak clearly and concisely. Ability to establish and maintain effective working relationships with patients, employees, and the public. EDUCATION: 1. High School Diploma or GED 2. Successful completion of a course in Medical Terminology EXPERIENCE: 1. Minimum of one year experience in a Medical Office 2. Computer Experience CERTIFICATE/LICENSE: None ALTERNATIVE TO MINIMUM QUALIFICATIONS: Additional appropriate education may be substituted for experience.

Responsibilities

The Pre-certification Specialist is responsible for obtaining pre-certifications for all therapy services and coordinating medical information with insurance companies. They also maintain accurate patient charts, document all actions, and address patient inquiries regarding precertification status.