What are the responsibilities and job description for the Precertification Specialist position at Adult Pediatric Urology & Urogynecology?
Precertifies procedures and verification of benefits in a timely manner. Counsel patients in regard to out of pocket expenses and collect payment for services rendered. Ensure a high level of customer service is maintained on patients’ accounts.
ESSENTIAL JOB FUNCTIONS/RESPONSIBILITIES:
1) Precertifies all surgeries/procedures for the office, hospital and other health care settings. (daily)
2) Verifies benefits for inpatient, outpatient and office procedures including Biofeedback and Urodynamics. (daily)
3) Sends pre-determination letters to payers as needed. (daily)
4) Collects patient payments via credit card or check at point of service or prior to procedure. (daily)
5) Processes Care Credit payments.
6) Verifies referrals from TriCare prior to office visit/procedures. (daily)
7) Enrolls and /or seeks preauthorization for specialty drugs such as Testopel, X-Geva, Prolia, etc., and contacts patients with their projected cost. (as needed)
8) Prepares deposit slip for all front desk collections, billing office and miscellaneous payments. (daily)
9) Reconciles PSA and Alegent labs with chart documentation and recommends payment to accounts payable .(weekly)
10) Act as a resource to patients and their families about their account balances and insurance questions.
11) Covers the duties of other team members as needed.
12) Adheres to Adult and Pediatric Urology policies and procedures, rules and regulations, and other State and Federal regulatory requirements.
13) Complete other duties as assigned.
14) Must work as a team member and perform actions consistent with established Adult & Pediatric Urology & Urogynecology policies and procedures including standards for safety, attendance, punctuality and personal appearance. Perform other duties as assigned.
Job Type: Full-time
Benefits:
- 401(k)
- Dental insurance
- Disability insurance
- Flexible schedule
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
Schedule:
- Day shift
- Monday to Friday
- No weekends
Education:
- High school or equivalent (Preferred)
Experience:
- Insurance verification: 1 year (Preferred)
- Medical billing: 1 year (Preferred)
Work Location: One location