Diagnostic Precert Specialist

• Contacts insurance companies and other third-party payers to determine preauthorization requirements for diagnostic services.
• Calls insurance companies or uses online tools to obtain preauthorization. Follows up timely and thoroughly.
• Ensures all preauthorization issues are communicated in a timely manner.
• Liaisons with the physician's staff to obtain additional insurance and/or clinical information.
• Reviews patients' charts and submits appropriate and pertinent information from the clinicals for medical necessity for the service.
• Follows up properly on all denials and peer-to-peer requests.
• Documents appropriately regarding all actions, authorization, and denials.

Do you have experience in Task prioritization?, Do you have a High school diploma or GED?, Full-time precertification specialist needed for multidisciplinary medical practice. Medical Office Personnel with administrative responsibilities focuses on obtaining pre-certifications and authorizations for diagnostic procedures for our orthopedic, neurosurgical, and pain management physicians. The candidate must be detail-oriented, focused, organized, and a team player with an attitude to contribute meaningfully to the practice., * Able to prioritize, work accurately, work well independently and able to maintain focus under pressure

• Working knowledge of medical terminology, insurance packages/plans and proficient with EMR
• Clearly communicate with providers, insurance companies and staff.
• Excellent verbal and written communication skills
• Excellent organizational skills, multi-tasking capabilities and detail orientated
• Customer Services skills
• Basic Computer/PC and Internet skills
• Attention to details and problem-solving skills
• Must be a great team player
• High School Diploma (Required)
• 1 year precertification experience (preferred)