Precertification Specialist - South County

Practitioners

Thank you for considering a career within Signature Medical Group!

We are looking for talented people to join our team of dedicated team members, and have career opportunities available at a variety of locations throughout the greater St. Louis and Kansas City regions.

All applicants MUST include a resume to be considered for a position with Signature Medical Group.

Date Posted: 12/8/2020
Department: Orthopedics - Human Resources
Type of Employment: Full-Time

JOB TITLE: Precertification Specialist

GENERAL SUMMARY OF DUTIES: The Precertification Specialist is responsible for obtaining prior authorizations for all procedural orders by successfully completing the authorization process with all commercial payers.

RESPONSIBILITIES

  • Review chart documentation to ensure patient meets medical policy guidelines
  • Prioritize incoming authorization requests according to urgency
  • Maintain individual payer files to include up to date requirements needed to successfully obtain authorizations
  • Initiate appeals for denied authorizations
  • Respond to clinic questions regarding payer medical policy guidelines
  • Contact patients to discuss authorization status
  • Other duties as assigned

KNOWLEDGE, SKILLS, AND ABILITIES

  • Knowledge of procedure authorization and its direct impact on the practice’s revenue cycle
  • Understanding of payer medical policy guidelines while utilizing these guidelines to manage authorizations effectively
  • Excellent computer skills including Excel, Word, and Internet use
  • Detail oriented with above average organizational skills
  • Plans and prioritizes to meet deadlines
  • Excellent customer service skills; communicates clearly and effectively
  • Ability to multitask and remain focused while managing a high-volume, time-sensitive workload

EDUCATION/EXPERIENCE REQUIRED

  • High School Diploma or GED
  • 1-2 years medical prior authorization experience preferred
  • 1-2 years’ experience in a medical related field required

Job Type: Full-time

Benefits:

  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Flexible spending account
  • Health insurance
  • Life insurance
  • Paid time off
  • Vision insurance

Schedule: 8 hour shift

Ability to Commute/Relocate: St. Louis, MO 63128 (Preferred)

Experience: Medical Billing: 1 year (Preferred)


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