Position Summary

Performs varied professional services to ensure medical/surgical and diagnostic/ancillary services are accomplished in an efficient manner and that reimbursement is maximized through required interaction with third-party payers.

Job Description

Primary Duties & Responsibilities:

• Initiates and facilitates pre-determination process.
• Contacts appropriate insurance companies for benefit verification and pre-certification of surgical and nonsurgical procedures; notifies financial counselor for pre-payment of un-coded services.
• Supplies all documentation required during pre-certification process to insurance companies.
• Maintains daily surgery/procedure schedule for department faculty; maintains open communication with physicians and their assistants regarding their schedules.
• Maintains 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.

Working Conditions:

Job Location/Working Conditions

• Normal working environment.
• Patient care setting.

Physical Effort

• Typically sitting at desk or table.
• Repetitive wrist, hand or finger movement.

Equipment

• Office equipment.

The above statements are intended to describe the general nature and level of work performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all job duties performed by the personnel so classified. Management reserves the right to revise or amend duties at any time.

Required Qualifications

Education:

High school diploma or equivalent high school certification or combination of education and/or experience.

Certifications/Professional Licenses:

No specific certification/professional license is required for this position.

Work Experience:

Medical Office Setting (2 Years)

Skills:

Not Applicable

Driver's License:

A driver's license is not required for this position.

Preferred Qualifications

Education:

Associate degree

Certifications/Professional Licenses:

Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC), Registered Health Information Technician (RHIT) - American Health Information Management Association (AHIMA)

Work Experience:

No additional work experience unless stated elsewhere in the job posting.

Skills:

Communication, External Customers, Insurance, Internal Customers, Interpersonal Communication, Managed Care, Medical Insurance Coding, Organizing, Third Party Payers

Grade

C08-H

Salary Range

$20.57 - $30.84 / HourlyThe salary range reflects base salaries paid for positions in a given job grade across the University. Individual rates within the range will be determined by factors including one's qualifications and performance, equity with others in the department, market rates for positions within the same grade and department budget.