Precert Specialist

Sports

MED Orthopaedic Surgery & Spine Center in Huntsville, AL, is seeking a Precertification Specialist to join our Billing and Insurance Team.

The Precertification Specialist reports to the Precertification Supervisor. Under indirect supervision, the Precertification Specialist performs pre-certification functions to ensure that all services requiring carrier authorizations are approved.

The duties associated with this role include but are not limited to:

• Verify insurance benefits and coverage for upcoming procedures and surgeries.
• Obtain precertifications and authorizations from insurance carriers in a timely manner.
• Communicate with physicians, clinical staff, and patients regarding authorization statuses and insurance requirements.
• Document all communication and authorizations in the EMR system accurately.
• Track pending authorizations and follow up as needed to ensure approvals are received before scheduled services.
• Stay current with payer policies, coding guidelines, and insurance verification protocols.
• Serve as a liaison between patients and insurance providers to answer questions or resolve issues.
• Coordinate with billing and scheduling departments to ensure all procedures are cleared before the date of service.

This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.