Medical Pre-Certification Specialist
Beacon Hill Staffing Group, LLC

Job Info

---

POSITION OVERVIEW

Under general supervision, the UR Therapy Pre-Certification Specialist confirms patient eligibility and benefits for all Medicare, Medicaid, Government, and all Commercial Carriers. Identifies and corrects internal problems within assigned accounts to expedite payments from insurance companies. Obtains precertification for required procedures as it relates to Physical and Occupational Therapy services. All required information is documented in Practice Management System in a timely and accurate manner prior the patient appointment. The position involves a large volume, calling patients and insurance companies. Serves as liaison between patient, insurance company, physician, therapist, and facility. Substitutes in other areas of the business office as needed.

JOB DESCRIPTION

Role and Responsibilities:
• Responsible for working from assigned Work Queues of scheduled New and Established Therapy procedures
• Verify insurance and benefits for scheduled Therapy procedures
• Obtain insurance authorization when needed
• Responsible for ensuring information in practice management system is correct
• Responsible for communicating with insurance companies, office staff/Provider, and patients as needed
• Responsible for following physician guidelines.
• Ability to work independently, prioritize task and to work under pressure and deadlines
• Ability to multi-task, responsible for following up on pending cases while initiating new cases
• Responsible for scanning documents into patients' chart within EMR
• Knowledge of medical terminology, with an emphasis on Physical and Occupational Therapy
• Ability to perform basic math calculations
• Follows all OSHA standards and guidelines
• Maintains patient confidentiality
• Performs other duties, responsibilities, and functions as may be required from time to time

Qualifications and Education Requirements

Education required:
• Associate degree preferred, but not required

Experience required:
• One year experience in medical insurance pre-certification
• Experience in utilizing insurance websites for verifying eligibility, benefits and obtaining pre-certification

Professional license or certification requirements:

N/A

Preferred Skills:
• Knowledge of insurance plans
• Knowledge of Medicare, Medicaid, CHAMPUS, and other government approved insurance regulations and guidelines
• Knowledge of medical terminology
• Skill in telephone etiquette
• Ability to perform basic math calculations.
• Skill in data entry.
• Ability to navigate Excel spreadsheets.

Beacon Hill is an Equal Opportunity Employer that values the strength diversity brings to the workplace. Individuals with Disabilities and Protected Veterans are encouraged to apply.

California residents: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.

If you would like to complete our voluntary self-identification form, please click here or copy and paste the following link into an open window in your browser: https://jobs.beaconhillstaffing.com/eeoc/

Completion of this form is voluntary and will not affect your opportunity for employment, or the terms or conditions of your employment. This form will be used for reporting purposes only and will be kept separate from all other records.

Company Profile:

Founded by industry leaders to set a new standard in search, career placement and flexible staffing, we deliver coordinated staffing solutions with unparalleled service, a commitment to project completion and success and a passion for innovation, creativity and continuous improvement.

Our niche brands offer a complete suite of staffing services to emerging growth companies and the Fortune 500 across market sectors, career specialties/disciplines and industries. Over time, office locations, specialty practice areas and service offerings will be added to address ever changing constituent needs.

Learn more about Beacon Hill and our specialty divisions, Beacon Hill Associates, Beacon Hill Financial, Beacon Hill HR, Beacon Hill Legal, Beacon Hill Life Sciences and Beacon Hill Technologies by visiting www.bhsg.com .

We look forward to working with you.

Beacon Hill. Employing the Future (TM)

---