Precertification Assistant – Percert Staff

PRECERTIFICATION ASSISTANT – PERCERT STAFF Virtual Req #4734 Thursday, August 10, 2023 Status: Full Time – 80 hours Hours: Monday-Friday 7-3 and shift varies In an environment of continuous quality improvement, t he Precertification Assistant is responsible for assisting with the review of scheduled tests and surgeries, to verifying insurance information and coverage, determine authorizations, medical necessity is obtained, or medical coverage, for proper payment of testing. Exhibits the MHS Standards of Excellence and exercises strict confidentiality at all times. Job Requirements: Minimum of 2 years’ experience in hospital, medical office or clinic setting in registration dealing with insurance issues and/or scheduling experience preferred Previous education in medical terminology, anatomy and physiology, or graduate/certification from medical office program preferred If no previous education, anatomy and physiology will be required within 6 months of employment Must have or be able to acquire and retain good knowledge of commercial, federal and state payor requirements Needs good telephone voice and skill in handling business transactions, including irate patients Ability to work with computerized system, also basic clerical and interpersonal skills and typing at 40 wpm Ability to read, write and do math as generally demonstrated by a high school diploma or GED Job Functions: Acquires skills and maintains knowledge of system applications/websites used in precertification. Determines if test/procedure requires authorization. Reviews order for completeness. Obtains appropriate authorization, checks medical necessity for Medicare patients, reviews Commercial Insurance medical policies to ensure proper payment from Insurance is received. Contacts the provider’s office via telephone or task to place a patient’s testing on hold if authorization isn’t obtained. Notifies the providers office if a Peer to Peer option is available. Tracks authorization information in all tabs of the authorization module. Assumes all other duties and responsibilities as necessary. Compensation Details: Education, experience, and tenure may be considered along with internal equity when job offers are extended. Minimum hiring rate for this position is listed below. Benefits Memorial Health System is proud to offer an affordable, comprehensive benefit package to all full time and flex time employees. Medical Insurance – PPO & HDHP Dental and Vison Insurance Health Saving Account Flexible Spending Account Dependent Care Pension Plan – Defined Contribution 403b Retirement Plan Voluntary Life Insurance Short-Term & Long-Term Disability Vacation Time Sick Time Holiday Pay & Premium Shift Differential Tuition Reimbursement Tuition Repayment Performance & Market Increases Relocation Package, if applicable Memorial Health System is an equal opportunity provider and employer. If you wish to file a Civil Rights program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, found online at https://www.ocio.usda.gov/document/ad-3027 , or at any USDA office, or call (866) 632-9992 to request the form. You may also write a letter containing all of the information requested in the form. Send your completed complaint form or letter to us by mail at U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, S.W., Stop 9410, Washington, D.C. 20250-9410, by fax (202) 690-7442 or email at [email protected] . Other details Job Family Non-Clinical Job Function Frontline Employee Pay Type Hourly Min Hiring Rate $14.33 Apply Now Share this job: