Performs professional services to support pre-certification and pre-determination workflows for medical, surgical, and diagnostic/ancillary services. The role helps ensure services are completed efficiently and reimbursement is maximized through coordination with third-party payers.
Key responsibilities include initiating and facilitating the pre-determination process, contacting insurance companies for benefit verification and pre-certification, supplying required documentation, maintaining surgery and procedure schedules, keeping logs of pre-certifications, and notifying the utilization/billing department when pre-certification is received.
Requirements & Qualifications
Required
- High school diploma or equivalent, or a combination of education and experience
- 2 years of experience in a medical office setting
- No certification or professional license required
Preferred
- Associate degree
- CPC (Certified Professional Coder)
- RHIT (Registered Health Information Technician)
- Skills in communication, insurance, managed care, organizing, third-party payers, and medical insurance coding
Benefits & Perks
Benefits
- Up to 22 days of vacation
- 10 recognized holidays
- Sick time
- Competitive health insurance with priority appointments and lower copays/coinsurance
- Free Metro transit U-Pass for eligible employees
- 403(b) retirement savings plan with employer contributions starting at 7%
- Wellness programs, health screenings, mental health resources, and EAP support
- Caregiver leave and family care resources
- Tuition coverage for employees and family members, including dependent undergraduate tuition benefits
Location
N/A
Employment Type
Full-time
Experience Level
Entry Level
Remote work allowed
Yes
Posted
1 week ago