Pre Cert Team Lead

The Pre-Certification Team Lead is responsible for obtaining approval from insurance companies for services that require referral, pre-certification or prior authorization.

Responsibilities

• All job functions are performed in a manner that promotes the highest level of compliance with various legal, regulatory and accreditation requirements while maintaining all protected health information in manner that complies with HIPAA requirements.

Requirements

• High School diploma or GED required.
• Proficiency working with computer applications, including Word, Excel and EMR/Billing systems required.
• Understanding of medical terminology and general medical billing processes, including accounts receivable required.
• Basic understanding of medical coding required.
• Broad understanding of insurance company requirements related to services that require referral, pre-certification or prior authorization required.
• Ability to process a high volume of work in an accurate manner required.
• Ability to communicate effectively both verbally and in writing required.
• Effective work habits including, regular and prompt attendance, dependability, teamwork and initiative required.

Preferred

• Three years of medical insurance or medical billing experience required.
• Two – three years of prior experience with pre-certifications preferred.