Precertification Specialist​/Scheduler

The Precertification Specialist/Scheduler will be responsible for scheduling procedures and obtaining prior authorizations by successfully completing the authorization process with all commercial payers.

Two years of experience in a medical-related field are required, along with a high school diploma or GED. General knowledge of surgery scheduling, medications and medical terminology required, and two years of medical prior authorization experience preferred.

This role will have the following responsibilities:

• Schedule surgeries for each doctor and create daily clinic schedule
• Review chart documentation to ensure patient meets medical policy guidelines
• Discuss Pre-op and Post-op instructions with each patient
• Prioritize incoming authorization requests according to urgency
• Collect deductibles/costs for each surgery
• Obtain authorization via payer website or by phone and follow up regularly on pending cases
• Maintain individual payer files to include up-to-date requirements needed to successfully obtain authorizations
• Respond to clinic questions regarding payer medical policy guidelines
• Confirm accuracy of CPT and ICD-10 diagnoses in the procedure order
• Contact patients to discuss authorization status
• Answer all patients’ questions about surgery/test/referral in a kind/understanding manner
• Other duties as assigned

This a full-time, in-person position with a Monday to Friday schedule.

• 401(k)
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

• Paid time off (PTO)
• Holiday PTO
• 401(k) plan
• Profit sharing plan