Pre Certification Assistant - COPC Sports, Spine & Joint

Job Description

This position works to obtain approvals for orders by submitting completed clinical information to insurance companies and their vendors.

Full Time/Benefits Eligible

Monday-Friday - 8:00am-4:30pm

Westerville, OH

ESSENTIAL FUNCTIONS AND RESPONIBILITIES:

Process routine orders in the date received in a timely manner. Identify urgent orders and process orders the same day received.

Verify insurance eligibility, complete pre-certifications as needed.

Compile all clinical data needed to support the criteria set forth by each payor’s guidelines.

Communicate with the ordering provider if additional clinical clarification or information is needed after submitting request.

Follow up on pending cases, respond to assigned telephone encounters, accurately document all activity of the case.

Collaborate with team to distribute workload and prioritize department needs.

Attend department and other related meetings.

QUALIFICATIONS:

Required: High school diploma

Preferred: Some college courses

Preferred: Minimum 2 years Pre-certification experience in a healthcare setting.

Knowledge Skills & Abilities

Excellent verbal & written communication skills

Knowledge of Microsoft Teams, Word, Excel and Outlook

Ability to execute job duties with precision and attention to detail

Ability to work both independently and together as a team

Ability to prioritize and organize work efficiently to complete work timely

Ability to accommodate and embrace ongoing change in systems, insurance guidelines and process

Strong time management skills

Possess a positive attitude

Possess strong problem solving, critical thinking skills

Full-time