Pre-Certification Coordinator

Job description

Description This position is a full-time, permanent onsite non-clinical position within Tennessee Orthopaedic Alliance in Columbia, TN. Responsibilities: - Promptly identify any errors or other issues in precert and test/surgery scheduling. - Communicate with insurance payer representatives, patients, and employees to ensure timely and accurate surgery schedule. This would include Commercial plans, Medicare/Medicare HMO plans, Medicaid/Medicaid HMO plans, and BCBSTN, etc. - Operate within established guidelines and protocols, including providing backup documentation such as office notes, test reports, etc. to carriers. - Obtains pre-certification/preauthorization from insurance companies prior to test or procedure - Manages patient insurance verification by utilizing multiple insurance websites, phone, fax, and other methods as needed - Timely follow up on all submitted verifications/pre-certifications - Notifies the physician regarding denials, and approvals, etc. Requirements: - Understanding of CPT and ICD-10 coding - Prior Precert experience - Knowledge of administrative and clerical procedures experience with an EHR or NextGen is a plus - Knowledge of Insurance – particularly...