Precertification Billing Lead at Ohio ENT & Allergy Physicians

Columbus, Ohio, United States -

Full Time

Start Date

Immediate

Expiry Date

19 Jun, 26

Salary

0.0

Posted On

21 Mar, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Precertification, Billing, Supervising Staff, Prior Authorizations, Workflow Optimization, Payer Websites, Appeals Initiation, Insurance Guidelines, Medical Terminology, Anatomy, ICD-10, CPT Codes, Communication Skills, Organization, Detail-Oriented

Industry

Hospitals and Health Care

Description

Description At Ohio ENT & Allergy Physicians we are dedicated to providing exceptional healthcare services to our community. We are looking for a motivated Precertification Billing Lead to join our dynamic billing department. We offer a competitive salary and benefits package, as well as opportunities for growth and advancement within our organization. Looking for a better work/life balance? Our career opportunities have Monday-Fridays work schedules. Competitive Pay & Benefits: Med/Dental/Vision, Paid Personal Time, Paid Holidays, 401K, Paid STD/LTD/Life Summary of Duties: The Precertification Billing Lead is responsible for overseeing the precertification process, ensuring compliance with insurance guidelines, and optimizing workflows. • Directly supervising staff responsible for precertification and prior authorizations, ensuring timely and accurate billing. • Monitor staff workflow to ensure precertification’s are completed in a timely manner. • Assist with obtaining authorization via payer websites or by phone • Follow-up on pending cases to ensure pre-cert is received prior to the scheduled procedure • Communicate with physicians and medical staff as needed and serve as the go between for clinical staff and administration. • Review monthly updates from individual payers for any changes in their pre-certification requirements and policies. • Initiate appeals for denied authorizations. PM20 Requirements • Qualified applicant should have at least 2 years experience working with insurance billing and precertification. • Previous supervisor experience preferred. • Good understanding of insurance plans and medical necessity guidelines. • Good knowledge of medical terminology & anatomy. • Proficient with ICD-10 & CPT codes • Qualified applicant should have previous experience with pre-certifying surgical procedures. • Excellent oral and written communication skills required. • Knowledge of AthenaHealth (formerly GE-Centricity) practice management software and EHR packages beneficial but not required. • Ability to establish and maintain effective working relationships with Physicians and all co-workers. • Must be well organized and detail-oriented. Education: High School Diploma

Responsibilities

The Precertification Billing Lead oversees the entire precertification process, ensuring compliance with insurance guidelines and optimizing workflows by directly supervising staff responsible for authorizations and timely billing. This role involves monitoring staff performance, assisting with obtaining authorizations, following up on pending cases, communicating with clinical staff, reviewing payer updates, and initiating appeals for denied authorizations.