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Pre-Certification Specialist

Full Time

Job Description

Determines if pre-certification or prior authorization is needed on any scheduled test or procedures by contacting patient’s carrier for information.  Obtains information needed to obtain pre-certification from proper source for payor.  Communicates information to pre-certification department.  Notifies ordering physician’s office if additional information is needed.  Documents pre-certification number in appropriate area of patient’s record.  Documents, in notes, all communication including, but not limited to, reference #s, people spoken with, etc.  Notifies office if pre-certification cannot be obtained.  Communicates with scheduling so that test can be removed from the schedule or changed.  Performs multiple tasks simultaneously keeping information organized for processing.  Follows all departmental and hospital polices. Ensures customer service policies and guidelines are followed.

Qualifications

Education Minimum of high school diploma, some college preferred. Experience Minimum of 2 years clinical experience, registration experience, knowledge of  pre-certification procedures, customer service skills, computer background, knowledge of keyboard, and typing (minimum of 40 wpm). Medical terminology required. Licenses, Certifications, and/or Registrations None Equipment, Tools, Work Aids Copy Machine, calculator, fax machine, Meditech, Windows, credit/debit card machine, printer as well as compliance checker. Specialized Knowledge and Skills Pre-certification and Prior Authorization Process, Problem Solving, Multi-tasking and Organizational skills.

Schedule

Monday-Friday 7:30am-4:00pm
Russell Medical
About Russell Medical

Exceptional healthcare awaits you at Russell Medical, located in Alexander City, Alabama close to the pristine waters of beautiful Lake Martin. Russell Medical is a progressive, not-for-profit, acute care facility serving the needs of east Central Alabama. Our mission is simple: Being the best because, we care. Inside our doors you will find cutting edge technology, professionals of the highest caliber, and leadership committed to utilizing all of our resources to improve the quality of every life we touch. Russell Medical has been accredited by The Joint Commission since 1959.

At Russell Medical we truly believe that employees are our greatest assets. Our goal is to provide a safe, friendly and supportive work environment. Each person is very important and performs a valuable service and we embrace and encourage the spirit of teamwork.

 https://drive.google.com/file/d/1JYsWgtX1UavKIsbPOd37Q-NsvbuqJC__/view?usp=sharing

 

Russell Medical offers flexible work schedules, maintains a competitive wage structure and offers a wide array of benefits including health, dental, vision, accident, cancer, and short and long-term disability insurance. Flexible Spending Accounts, 529 Education Plan, and 403 (b) retirement plan. Tuition reimbursement and other educational assistance may be made available. Fulltime employees accrue Paid Time Off as well as an additional accrual for sick time.

Russell Medical is an equal opportunity employer. We invite you to join our dedicated team and become a part of the Russell Medical family.

 

Russell Medical Foundation (Scholarships):

The Russell Medical Foundation awards healthcare scholarships annually. For detailed information, contact Judy Wood, Foundation Administration at 256-329-7152.  Please click links below for further information:

Foundation-Scholarship-criteria (1)

Foundation High school application draft (2)

Healthcare scholarship criteria

Healthcare Scholarship application draft (3)

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