Precertification Analyst

Description

• Job Summary

◦ The Precertification Specialist obtains authorizations from Insurance companies for scheduled tests / procedures providing necessary medical information for authorizations. Interprets patient medical records and reviews cases with the insurance nurse reviewer. Accurately enters information into multiple computer programs and insurance websites.

◦ Education

▪ Required : High School Diploma or Equivalent

▪ Preferred : Medical Assistant Degree

◦ Experience

▪ Required : 1 Year Related Experience

▪ Preferred : 6 months experience with medical terminology

◦ Skills

▪ Strong analytical / problem solving skills.

▪ Ability to communicate effectively with different levels of management, nursing, physicians, and insurance nurse reviewers.

▪ Excellent time management, Communication skills, organization, prioritizing, decision-making, and planning skills.

▪ Flexibility and ability to work in a multi-tasking environment.

▪ Ability to understand and interpret insurance benefits

▪ Ability to understand multiple computer programs and multiple insurance websites.

◦ Licensure / Certification / Registration

▪ N / AEducation : ▪ Required : High School Diploma or Equivalent ▪ Preferred : Medical Assistant Degree

Experience : ▪ Required : 1 Year Related Experience ▪ Preferred : 6 months experience with medical terminology

Skills : ▪ Strong analytical / problem solving skills. ▪ Ability to communicate effectively with different levels of management, nursing, physicians, and insurance nurse reviewers. ▪ Excellent time management, Communication skills, organization, prioritizing, decision-making, and planning skills. ▪ Flexibility and ability to work in a multi-tasking environment. ▪ Ability to understand and interpret insurance benefits ▪ Ability to understand multiple computer programs and multiple insurance websites.

Licensure / Certification / Registration : ▪ N / A