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“Southern Ohio Medical Center” Company Details
| Company Name | Southern Ohio Medical Center |
| Rating | 3.8 |
| Job Type | Full-time |
Pre-Cert-Insurance Authorization Specialist Job Overview
Shift/Schedule: Full Time (40 hrs/wk), Remote.
Works under the supervision of the Outpatient Prior Authorization supervisor and Lead.
What to do in Southern Ohio Medical Center company Job
Current Employees: If you are currently employed at SOMC please log into UKG Pro to use the internal application process.
Department: Central Scheduling
Shift/Schedule: Full Time (40 hrs/wk), Remote
GENERAL SUMMARY
Works under the supervision of the Outpatient Prior Authorization supervisor and Lead. The Pre-Cert/Insurance Authorization Specialist primary job functions are to perform professional orderly, efficient insurance verification and pre-cert. The Pre-Cert/Insurance Authorization Specialist responsibilities are to verify insurance coverage/eligibility, obtain pre-certification/prior authorization, and benefit information through online systems and calling the insurance companies. Is responsible for safeguarding the public relations and confidentiality of the hospital and its records by consistent professional conduct. Performs other duties as assigned.
QUALIFICATIONS
Education:
- High School Diploma or successful completion of an equivalent High School Exam Required.
Licensure:
- None
Experience:
- Experience with computers required
- Six months of related work or hospital billing experience preferred
- Insurance knowledge preferred
- Medical terminology preferred
- Insurance verification and authorization experience preferred
- Knowledge of CPT/ICD 10 codes preferred
JOB SPECIFIC DUTIES AND PERFORMANCE EXPECTATIONS
The following is a summary of the major job duties of this job. Other duties may be performed, both major and minor, which are not mentioned below. Specific activities may change from time to time.
- Collects accurate financial, demographic and clinical data involving interaction with patients, physicians, insurance companies and outside agencies to meet the SOMC and team standards.
- Verifies coverage and eligibility, obtains Authorizations on Surgery, Outpatient testing, Homecare visits, Cardiac Rehab visits, as appropriate.
- Collects and maintains various departmental records, logs and statistical data timely and accurately as identified by the Supervisor. Documents all correspondence, telephone calls and account activity in the electronic record
- Assists in training and education of employees.
- Collaborate with Central Scheduling, Surgeon offices, registration, and diagnostic imaging depts, to secure the prior auth and verify coverage.
- Meeting SOMC and team standards, meeting productivity and quality guidelines.
- Obtains retro-authorizations as needed
Thank you for your interest in Southern Ohio Medical Center. Once you have applied, the most updated information on the status of your application can be found by visiting the candidate Home section of this site. Please view your submitted applications by logging in and reviewing your status.
Southern Ohio Medical Center is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to age, ancestry, color, disability, ethnicity, gender identity, or expression, genetic information, military status, national origin, race, religion, sex, gender, sexual orientation, pregnancy, protected veteran status or any other basis under the law.
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