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Precertification Specialist
Heart and Vascular Care
Alpharetta, USA
Full-time
Entry
Hybrid
Discovered 2 weeks ago
ICD-10CPTpayer portals
Key Skills for This Role
ICD-10CPTpayer portals
Full Job Posting
Duties may include but not limited to
- Responsible for obtaining complete and accurate insurance information, benefit verification, accurately interpreting benefit plans and investigating pertinent details. Notifies supervisor of known or potential issues.
- Utilize ICD-10 and CPT codes to ensure proper authorization for procedure and claims payment.
- Responsible for explaining benefits, the billing process and financial responsibilities to patients.
- Responsible for ensuring treatment is medically necessary, align with established standards, payer guidelines and are approved within the required timeframe.
- Maintain accurate documentation of authorization and other related information.
- Utilization of payer portals
- Record all communication with providers and personnel in standardized documentation and proper format
- Review denial reasons and follow the appeal process in a timely manner. Arrange peer to peer, if applicable.
- Provides detailed, accurate and current clinical information to insurance representatives complying with HIPAA regulations.
Requirements
- Dependable team player is a must.
- Ability to work in a fast paced environment.
- Prior medical experience is required.
- Heart and Vascular Care is a cardiology practice that places a priority on compassionate patient care and service. In our team-based and family-oriented setting, we strive to set a new bar for patient healthcare through a modern, friendly, and thoughtful approach.
- Come be a part of our growing team. Apply and someone will be in touch!
About Heart and Vascular Care
Physician Practices & Outpatient Clinics117 employeesFounded 2007
Private Georgia cardiovascular practice providing cardiology, vascular, vein, and diagnostic care across metro Atlanta and North Georgia.
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