Precertification Specialist

Paul Phillips Eye & Surgery Center has two open positions: one Full-Time and one Part-Time.

Paul Phillips Eye & Surgery Center, a leading provider of ophthalmology services in Hunterdon and Somerset counties, is seeking a highly organized and detail-oriented Precertification Specialist to join our team in Flemington, NJ. The Precertification Specialist plays a vital role in ensuring patients receive timely access to care by managing and coordinating the precertification process for medical services and procedures related to ophthalmology.

This position serves as a key liaison between healthcare providers, patients, and insurance companies, requiring strong communication skills, a working ثبت knowledge of insurance processes, and the ability to navigate electronic health records (EHR) systems efficiently.

• Obtain prior authorizations from insurance companies for ophthalmology procedures, tests, and services.
• Review patient medical records and relevant documentation to support precertification requests.
• Act as a liaison between ophthalmologists, patients, and insurance companies to facilitate the precertification process.
• Accurately enter and maintain insurance authorizations in the EHR system.
• Track and follow up on pending authorization requests, ensuring timely approvals and addressing any issues.
• Collaborate with clinical staff, billing departments, and insurance representatives to maintain smooth workflow.
• Keep patients informed about pre‑authorization outcomes and provide necessary procedure codes.

• Strong and confident communication and interpersonal skills to interact effectively with patients, providersoeid and insurance companies.
• Excellent organizational skills and attention to detail in managing patient records and documentation; ability to prioritize.
-Benz
• Excellent follow‑up and follow‑through with a focus on accuracy and meeting important deadlines.
• Ability to work independently and as part of a team in a fast‑paced, multi‑specialty ophthalmology practice.
• Proficiency in using electronic health record (EHR) systems;
  Next Gen experienceिऱ् is a plus.
• Familiarity with Microsoft Outlook and general computer proficiency.
• Positive and professional demeanor with a commitment to exceptional patient care, aligning with the values of Paul Phillips Eye & Surgery Center.