Pre-Certification Coordinator I – Department of Medicine

Responsibilities

• Initiates and facilitates pre-determination process
• Contacts insurance companies for benefit verification and pre-certification
• Notifies financial counselor for pre-payment of un-coded services
• Maintains daily surgery/procedure schedule for department faculty
• Maintains communication with physicians regarding their schedules
• Keeps a written log of all pre-certifications in process
• Notifies hospital utilization/billing department of pre-certification
• Documents when pre-certification is received from insurance companies
• Performs other duties as assigned

Requirements

• High school diploma or equivalent high school certification or combination of education and/or experience
• 2 years of medical office setting experience
• Communication, External Customers, Insurance, Internal Customers, Interpersonal Communication, Managed Care, Medical Insurance Coding, Organizing, and Third Party Payers skills

Core Competencies

Demonstrates expertise in pre-certification processes, benefit verification, and medical insurance coding while maintaining effective communication with internal and external customers. Proficient in organizing schedules and managing interactions with third-party payers.