Pre Cert Lead Coordinator - Savannah, GA

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Full-time Regular Savannah DeRenne, Savannah, GA, US

5 days ago Requisition

Optim Orthopedics is seeking a full time Pre-Certification Lead Coordinator for our Savannah location.

Job Requirements:

• Verifies benefits and coverage for all 7 Optim Therapy locations.
• Ensures all pre-certifications are completed within the designated insurance company turnaround time parameters as required for review and communicates in a timely manner the outcome of these efforts to all appropriate entities.
• Communicates with front office and clinicians about authorizations.
• Completes benefit sheet and sends to appropriate clinic.
• Reviews patients' medical records for appropriate documentation for the scheduled procedure and accurate insurance as appropriate.
• Starts and/or completes all pre-certification and benefits for all Physical and Occupational therapy. Sends off for additional authorization same day for all patients that are Evaluation only.
• Follows up monthly with insurance companies ensuring that coverage is in effect until the procedure is performed.
• Documents all actions electronically and maintains permanent electronic record in patients' chart and necessary electronic data repositories as required.
• Completes all necessary actions in the pre-cert tool with dates and times as well as maintains all other computer systems associated with each procedures - i.e. scheduling systems, Paragon, APTA, Athena, Group Cast, etc.
• Answers patient questions and inquiries regarding the pre-certification status of their procedures.
• Maintains strict confidentiality of sensitive information.
• Travels to other work sites as necessary.