Precertification Assistant
Precertification Assistant
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Salary Not Disclosed
1 Vacancy
Job Description
Central Ohio Primary Care is seeking a Precertification to join our Precertification Department located in Westerville OH. The Precertification Assistant is responsible for processing orders for high tech radiology cardiac testing and medication prior authorizations to be performed at Central Ohio Primary Care. This position works to obtain approvals for orders by submitting completed clinical information to insurance companies and their vendors. This position works closely with ordering providers to ensure quality and timely patient care. This role will be full-time working first shift hours Monday- Friday.
ESSENTIAL FUNCTIONS AND RESPONIBILITIES:
- Process routine orders in the date received in a timely manner. Identify urgent orders and process orders the same day received.
- Verify insurance eligibility complete pre-certifications as needed.
- Compile all clinical data needed to support the criteria set forth by each payors guidelines.
- Communicate with the ordering provider if additional clinical clarification or information is needed before submitting request.
- Follow up on pending cases respond to assigned telephone encounters accurately document all activity of the case.
- Collaborate with team to distribute workload and prioritize department needs.
- Attend department and other related meetings.
QUALIFICATIONS:
- Required: High school diploma
- Preferred: Some college courses
- Preferred: Minimum 2 years Radiology Pre-certification experience in a healthcare setting preferred.
Knowledge Skills & Abilities
- Excellent verbal & written communication skills
- Knowledge of Microsoft Teams Word Excel and Outlook
- Ability to execute job duties with precision and attention to detail
- Ability to work both independently and together as a team
- Ability to prioritize and organize work efficiently to complete work timely
- Ability to accommodate and embrace ongoing change in systems insurance guidelines and process
- Strong time management skills
- Possess a positive attitude
- Possess strong problem solving critical thinking skills
Employment Type
Full-Time
