Pre-Cert Clerk

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.

These include but are not limited to the following:
• Verifies insurance coverage for patient exams, makes written and/or verbal inquiries to third party payers to verify insurance status and pre-certification status
• Stays abreast of patients added throughout the day and insures authorizations are processed prior to exam.
• Performs various administrative tasks to expedite the verification process, including documentation of guarantor information, patient information and protocols, and medical record reproduction.
• Participates in educational programs, in-service meetings, and workshops.
• Maintain patient confidentiality is crucial.
• Demonstrates exemplary telephone etiquette skills.
• Works closely with all centers to make sure all patients are authorized before doing exam.
• Calculates patient fees and explains fees to patients; sets up payment plans and gets approval from supervisor as needed; notifies patient of change in authorization.
• Works with Physician offices to: o clarify physician’s orders; o clinical records for authorizations o obtains the appropriate procedure code and o enters into the medical system; obtains.
• Recognizes variations and takes action to prevent undesirable appointment cancellations due to exams not being authorized; works with billing to resolve any insurance denials.
• Performs other duties as assigned.
• High School Diploma or equivalent;
• Minimum of one (1) year of customer service experience required.
• One (1) year experience working in a medical related office preferred.
• Experience and knowledge in handling telephones, computer terminals.