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Develops and maintains reference manuals that outline the individual payer requirements as it relates to pre-certification and pre-authorization needs. May provide back-up pre-certification/prior authorization resources for other departments as needed.
$17.15 - $21.44Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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A DAY IN THE LIFE OF A PRE-CERTIFICATION SPECIALIST Being a part of the Pre-Certification/VOB team you will complete a variety of tasks each day in a very fast-paced environment.
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Bring kinship and resource parent's files to full pre-certification, including a home Study report that describes all documentation found on file. Exercise prudent and all efforts to assist kinship/resource parent achieve and maintain full certification.
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Position Overview: As a Pre-Certification Specialist, you will play a crucial role in obtaining insurance pre-authorizations for medical procedures and services, contributing to the seamless functioning of our pain management practice.
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Optim Orthopedics is seeking full time Pre-Certification Specialist for our Pooler location. Starts and/or completes all pre-certification and benefits for all Physical and Occupational therapy.
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Verifies benefits, extent of coverage, pre-certification and pre-authorization requirements. Knowledge of other front-end processes, including scheduling, pre-registration, financial counseling, insurance authorization, medical necessity, and registration.
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Notifies the pre-admission case manager/nurse liaison of payer benefits and requirements for pre-authorization/pre-certification to maximize reimbursement. Notifies the pre-admission case manager/nurse liaison of payer benefits and requirements for pre-authorization/pre-certification to maximize reimbursement.
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If assigned to complex Pre-Reg: Collect and verify required patient demographic and financial data elements, including determining a patient's financial responsibility and securing pre-payment for future services/performing collection efforts Create a complete pre-registration account for an upcoming inpatient/surgical admission Completes all pre-certification requirements by obtaining authorization from insurer and/or healthcare facility.
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EDUCATION/EXPERIENCE: The Pre-Op / PACU RN must have a minimum of two years experience in the surgical suite setting, pre/post experience, critical care and ER experience preferred; an active, unrestricted license in the state of Pennsylvania; and BLS, ACLS, and PALS certification.
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Understands and utilizes all systems appropriately as related to scheduling, pre-registration, insurance verification, estimations, electronic order system, pre-certification, and phone quality controls.
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Responds to all inquiries from throughout the system and outside related to authorization/pre-certification issues. Provides clinical information as needed, emphasizing medical justification for procedure/service to insurance companies for completion of pre-certification process.
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AUTOMOTIVE PRE-OWNED SERVICE TECHNICIAN Are you a technician interested in a TIERED Pay Plan, Longevity BONUS Program, Warranty Book Time x 1.5, 4-Day Work Week and so much more? High School Diploma or GED. Michigan Mechanic Certification Essential Duties & Responsibilities: Receive repair orders from dispatcher and take to stall area.
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Must be able to obtain Operations and Maintenance certification for asbestos removal. Possession of a 7G cooling tower applicator certification or must be able to obtain in first year of hire.
$40,193 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Requires completion of an EMR or EMT Basic National Certification course; or certification as a nursing assistant (CNA) or medical assistant (MA) or completion of one clinical semesters of nursing school, or completion of a Combat Lifesaver or similar course, or completion of 6 months EMS or ED experience, or completion of one year of (non-pre-hospital/ED) hospital experience.
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If pre-certification/authorization/notification of admission is required and has not been obtained, initiate via Passport, on-line or phone call. Verify insurance benefits and determine pre-certification/authorization status via online or other resources.
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