[Hiring] Precertification Coordinator @Neurocare Inc

Role Description

The Precertification Coordinator works as part of a team with responsibility for providing customer service to a wide range of internal and external customers within a busy clinical setting.

• Coordinates all precertification aspects for sleep study referrals.
• Facilitates precertification information with the referring physician.
• Educates the patient on the precertification process.
• Works with the patient and physician to identify alternatives when a precertification is denied.

Essential Functions:

• Identifies payor coverage and makes online and/or verbal inquiries to third party payers to verify pre-certification status.
• Performs various clerical tasks to expedite the precertification process, including documentation of patient information and medical record reproduction.
• Works with physicians to ensure optimal documentation of medical necessity.
• Coordinates referrals from the PCP to the specialist ordering a sleep study.
• Provides precertification information received from the referring physician to the payor and monitors for decision outcome.
• Communicates outcome to physician and patient.
• Communicates with physicians to clarify orders or request an alternative study as approved by the payor.
• Identifies and communicates changes to precertification criteria, requirements, and processes as required by payors.
• Verifies information obtained is accurately entered into patient account platforms.
• Communicates regularly with customers, insurance companies, and healthcare providers.
• Enters detailed notes in patient database regarding communication with customers and steps taken in the verification process.
• Works closely with other team members, client administrative staff, and physicians to ensure the highest level of customer service and compliance with regulatory guidelines.

Qualifications

• High school diploma or GED.
• Bachelor's degree preferred.
• Medical background and knowledge of medical terminology preferable.

Requirements

• Excellent organizational and communication skills.
• Excellent time management skills with meticulous attention to detail.
• Good team and interpersonal skills.
• Ability to multi-task and handle a variety of situations at one time.
• Outstanding customer service skills.
• Computer skills in Word and Access; ability to be trained, understand, and use new software programs.
• Strong critical thinking and problem-solving skills.

Benefits

• Great introduction to Healthcare Administration.
• Promotes from within (many of our coordinators have been promoted to other positions within the company).
• Dynamic, professional environment.
• Excellent training.
• Independent work within a team environment.
• Learn about the exciting field of sleep medicine.