St. Joseph’s/Candler Health System
Precertification Specialist Assistant
St. Joseph’s/Candler Health System, New York, New York, United States
The PreCertification Specialist Assistance (PSA) is responsible for reviewing scheduled elective accounts to ensure that certification has been obtained. The PSA will maintain open communication and be available to component organizations and practitioner sites for consultation. The PSA will provide excellent internal and external customer service and maintain a working knowledge of industry standards to ensure timely, quality services in accordance with contractual agreements, federal regulations, hospital policies, procedures and professional standards.
Education High School Diploma - Preferred
Experience 2-3 Years Clerical - Required
1-2 Years Insurance - Preferred
License & Certification None Required
Core Job Functions
Compile and distribute daily service report. Review account to determine if certification is required. Work with physician offices and other hospital departments to make sure required certification is obtained and documented.
Determine if authorization is required. Accurately documents account information.
Monitor various reports for precertification need. Perform initial review prior to date of service and concurrent review until precertification obtained. Communicate and collaborate with other departments to eliminate precertification denials.
Review updated information from payers, monitor web portal alerts from payer. Maintains updated files on specific payer requirements.
Not the right fit? Join our Professional Talent Network and learn more about all current and future job opportunities.
Learn more about the many benefits available to SJ/C co-workers. From wellness programs and insurance options to child care and housing opportunities, SJ/C invests in the health and well-being of our co-workers in many ways. Click here to learn more.
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Education High School Diploma - Preferred
Experience 2-3 Years Clerical - Required
1-2 Years Insurance - Preferred
License & Certification None Required
Core Job Functions
Compile and distribute daily service report. Review account to determine if certification is required. Work with physician offices and other hospital departments to make sure required certification is obtained and documented.
Determine if authorization is required. Accurately documents account information.
Monitor various reports for precertification need. Perform initial review prior to date of service and concurrent review until precertification obtained. Communicate and collaborate with other departments to eliminate precertification denials.
Review updated information from payers, monitor web portal alerts from payer. Maintains updated files on specific payer requirements.
Not the right fit? Join our Professional Talent Network and learn more about all current and future job opportunities.
Learn more about the many benefits available to SJ/C co-workers. From wellness programs and insurance options to child care and housing opportunities, SJ/C invests in the health and well-being of our co-workers in many ways. Click here to learn more.
#J-18808-Ljbffr