"Billing Tech PreCert"

Position Summary

Rutgers, The State University of New Jersey, is seeking a Billing Tech Precert for the department of Medicine at the Robert Wood Johnson Medical School. The primary purpose of this position is to provide procedure pre-certification services for a department at the Rutgers Robert Wood Johnson Medical School. This entails providing patient information to insurance companies to support procedures requested by department physicians. Heavy telephone volume. Confidentiality and the ability to work independently are critical to the success of this assignment.

Key Duties:

• Monitors scheduled procedures and maintains organized list with status of pre-certification process.
• Verifies insurance eligibility and benefits via phone and/or internet access. Updates insurance policy information, as required.
• Checks insurance payment policy for scheduled procedures and obtains prior authorization when required.
• Verifies receipt of all necessary pre-authorization documents prior to procedure.
• Communicates effectively and updates EMR with all actions taken during precertification process.
• Assigns appropriate ICD9 and CPT codes pre-operatively based on documentation and booking slips.
• Notifies primary care physician for managed care plans that require PCP authorization.

Minimum Education and Experience:

Four (4) years of general office/billing experience, three (3) years of which shall have been in a physician, hospital or health center billing setting, including management of various types of insurance billing processes. Experience in accessing and retrieving information from a computer database is required.

Physical Demands and Work Environment:

Physical Demands: Standing, sitting, walking, talking and hearing. No special vision requirements. Lifting up to 25 lbs. Work Environment: Office environment with moderate noise.