Pre Certification Coordinator

Description

Do you enjoy working in a fast-paced office where your attention to detail skills really shine? Is providing excellent customer service something you strive for every day? If so, we have a job you should consider! This position is responsible for verifying patient's insurance benefits and eligibility, obtaining required authorization, providing procedure codes and fee estimates, and collecting prepayment from patients. 

Duties & Responsibilities:

• Monitor tasks and maintains information in patient chart with status of pre-certification process; Verify receipt of all necessary pre-authorization documents prior to procedure
• Verify insurance eligibility and benefits via phone and/or internet access.  Update insurance policy information in NextGen system as required.  
• Check insurance payment policy for scheduled procedures and obtain prior authorization when required.
• Communicate the status of the precertification effectively with the facility in which the procedure will be performed as needed.
• Assign appropriate ICD10 And CPT codes pre-operatively based on documentation. 
• Notify primary care physician for managed care plans that require PCP authorization.
• Supply patients with written or verbal estimates of codes and fees upon request. 
• Communicate financial expectations and the billing process to patients prior to their procedure. 
• Collect pre-payment from the patient when necessary. 
• Notify patients with past due accounts of pre-payment policy for elective services.  Collect payments from patients. 
• Serve as a resource on insurance, billing and customer service for staff.

Requirements

• High School Diploma or GED
• 2 – 3 years previous experience working in a health care environment. Prior precertification and medical coding experience preferred.
• Ability to maintain strict confidentiality. 
• Ability to work in a collaborative team environment and build strong relationships
• Possess excellent customer relation skills
• Excellent verbal and written communication skills; presentation skills a plus
• Ability to adapt to change and work in a fast-paced environment.
• Detail-oriented with strong organizational and problem-solving skills.

Compensation: The compensation range for this position is $18.00 to $23.00. Actual compensation within that range will be dependent upon the individual’s skills, education, experience, and qualifications.

Albany ENT & Allergy Services is proud to have been named a Best Place to Work in the Capital Region for 2023, 2024 and 2025. Albany ENT offers a consistent schedule with no weekend hours, a competitive salary, and a comprehensive benefits package, which includes health insurance, generous paid time off, and paid holidays.

If you are looking for a new opportunity with a practice that values their employees, believes in work/life balance, and prides itself on delivering compassionate, patient-centered care, we encourage you to APPLY TODAY!