What are the responsibilities and job description for the Pre-Certification Clerk - CVT Outpatient (Full Time) - 7131 position at Wroblewski & Newsom, PLLC?
St. Mary's Medical Center is seeking Full Time a Pre-Certification Clerk to work at CVT Outpatient Department. This individual is responsible for ensuring all services provided are reviewed for pre-certification and/or pre-authorization requirements. Using resources available, will obtain certifications and/or authorizations in accordance with medical center policies.
- Ensure registrations/encounters are completed and accurate.
- Verify all insurance and obtain precertification/authorization.
- Ensure that all necessary signatures are obtained for treatments.
- Answer any questions and explains policies clearly.
- Verify insurance benefits and determines precertification status. If precertification is needed, call the insurance pre-cert department and initiate review or verify authorization number provided by scheduling staff. Enter all information and authorization numbers into the registration system.
- Obtain proper authorization for treatment and approval codes from the insurance carrier for patients presenting for treatment insured by an MCO.
- Work with physician offices and ancillary departments, providing information when necessary or forwarding relevant documents.
- Check for physician orders and attaches them to the patient medical records to ensure that patients are receiving appropriate tests.
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