Huntsville Hospital Health System

AR Precertification Specialist

Clinical Support & Patient AdministrationUpdated on Nov 10

Full-timeDecatur, AL, USANo salary listedIn-person

About the Job

Requirements

High school diploma or GED.
Knowledge of coding, accounts receivable, and insurance reimbursement is required.
Ability to work under pressure.
Strong organizational and writing skills.
Ability to speak clearly and concisely.
Ability to work independently and demonstrate initiative.

Responsibilities

Pre-certify patients for office visits, consultations, testing, and procedures according to each patient’s insurance requirements by monitoring patient schedules in the billing system for each department.
Follow insurance company pre-certification requirements to obtain approval, including by phone, fax, email, or online systems.
Assist accounts receivable, coding, registration, and insurance follow-up staff as needed.
Respond to requests from various departments about pre-certification requirements for insurance companies.
Review insurance company pre-certification requirements promptly and maintain up-to-date knowledge of them.
Notify appropriate staff of approval or denial status.
Forward denials to the manager and appropriate staff for further review and decision-making.
Maintain strict confidentiality.
Perform other duties as assigned.

Desired Qualifications

Three years of insurance and/or billing experience is preferred.
One year of healthcare experience is preferred.

Overview

The Orthopaedic Center is looking for a highly motivated AR Precertification Specialist for our affliliate, DOC Orthopaedic and Sports Medicine. This opening is a full-time position averaging 40 hours per week. The AR Precertification Specialist will pre-certify all patients for office visits, consultations, testing, and procedures as required by each patient’s insurance company by monitoring patient schedules in the billing system for each department. Follow insurance company pre-certification requirements for approval, such as calling, faxing, emailing, logging into their system online, etc. Assist accounts receivable, coding, registration, and insurance follow up staff on an as-needed basis. Answer requests from various departments regarding pre-cert requirements for various insurance companies. Reviews pre-cert requirements for insurance companies in a timely manner to maintain up-to-date knowledge of requirements. Notifies appropriate staff on status of approval/denials. Forwards denials to manager and appropriate staff for further review and decision making. Maintains strict confidentiality. Performs other duties as assigned.

Qualifications

Education required: HS/GED

Experience: Coding, AR, Insurance reimbursement knowledge required. Three years insurance and/or billing experience preferred. One year of healthcare experience preferred.

Additional Skills/Abilities:

Ability to work under pressure
Outstanding organizational and writing skills
Ability to speak clearly and concisely
Independent, self-starting and highly motivated
Proven positive, "teamwork" attitude in work history

About Us

At The Orthopaedic Center, we are proud to be the region’s leading orthopaedic group, dedicated to delivering exceptional patient care. As our team continues to grow, we are seeking motivated professionals who are passionate about excellence, collaboration, and making a difference in the lives of our patients. Join our dynamic and expanding organization and become part of a team committed to outstanding orthopaedic care.

About the Company

Huntsville Hospital Health System

Company size: Not listed
Company stage: Not listed
Total funding: Not listed
Headquarters: Not listed
Founded: Not listed

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