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Precertification Representative

Stamford Health, Inc.
Stamford, USA
Full-time
Junior · 1–2 years experience
Onsite
Discovered 1 weeks ago

Full Job Posting

Responsibilities

  • Performs timely insurance verification/eligibility processes utilizing the practice management system, automated electronic eligibility functionality, various reports, and the third party payer websites and customer service telephone contacts relations to ordered/scheduled therapeutic procedures, medications, surgeries and diagnostic testing.
  • Ensures that all insurance, demographic and eligibility information is obtained and entered into the system in an accurate manner per established Practice policies and procedures. Communicates with patient to identify missing information and make corrections as needed.
  • Contacts insurance companies on behalf of the Practice and the patient to initiate and complete the pre-certification/authorization process as required by the patient's insurance company for ordered procedures, surgeries and diagnostic testing.

Qualifications

  • High School Diploma or General Education Development (GED) required. Clinical training a plus.
  • 1-2 years of previous insurance verification, pre-certification/pre-authorization, medical billing or other related experience in healthcare environment.
  • High level of competency with computers, electronic medical records, the Internet, and computer software such as MS Office or equivalent is required.
  • Knowledge of medical office operations, coding, and billing, medical terminology and third party insurance processes is required.

Preferred Qualifications

  • High School Diploma or General Education Development (GED) required. Clinical training a plus.

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