Surgery Precert Specialist

Overview

This position is responsible for verifying benefits for all outpatient/inpatient surgery patients as well as in-office procedures. Additionally, you will be responsible for correctly coding all procedures using current CPT coding guidelines. Also, responsible for obtaining any prior authorizations needed for in-office or facility procedures as well as entering hospital consultation and surgery charges for billing purposes. This position is also responsible for contacting patients to make them aware what their benefits are and any financial responsibility that will be due prior to surgery.

• Verify benefits for all outpatient/inpatient surgery patients and in-office procedures.
• Code all procedures using current CPT coding guidelines.
• Obtain prior authorizations for in-office or facility procedures.
• Enter hospital consultation and surgery charges for billing purposes.
• Contact patients to explain benefits and any financial responsibility prior to surgery.

• Prior experience with insurance verification from all insurance carriers - commercial and Medicare.
• Prior experience in obtaining prior authorizations for surgical procedures.
• Medical terminology knowledge is beneficial.
• Must be able to work independently as well as part of a team.
• Ability to organize, prioritize and manage multiple tasks simultaneously.
• Have strong verbal and written communication skills for interacting with patients, insurance companies and healthcare providers.
• Time Management is vital as is the ability to meet deadlines.
• Proficiency in using insurance portals as well as Word, Excel and other carrier sites.