Pre-Certification Specialist

## Description **GENERAL STATEMENT OF DUTIES:** Responsibilities include pre-certification/authorization of all diagnostic testing and in-office injections, as well as scheduling diagnostic testing ***Schedule: Monday-Friday 8am-5pm*** **Benefits:** - *401(k) matching + profit sharing* - *Health/Dental/Vision Insurance* - *FSA/HSA options* - *Life insurance/AD&D/STD/LTD* - *Paid time off* - *Employee Discount Program* - *Wellness Program* **RESPONSIBILITIES / WORK REQUIREMENTS:** **Pre-Certification:** - Verifies insurance coverage to obtain precertification/authorization for all radiology tests, specialty injections, and other services as needed. - Maintains contact with testing facilities regarding scheduled tests/STAT orders - Faxes all pre-authorized services to facilities, and makes any changes, as needed. - Enters benefits and precertification/authorization into EMR system. - Follows up daily on all pending orders, obtaining office notes if needed for insurance companies **REQUIRED KNOWLEDGE** - High school graduation or GED; post graduate degree preferred - At least one year of work experience in a medical office setting - Knowledge of medical office procedures and insurance verification and Pre-Certification - Ability to demonstrate a mature, dependable, and responsible approach when interacting with patients, physicians, co-workers, and additional outside sources - Proactive self-starter - Understands referral requirements of major third party payers - Ability to multi-task, prioritize and exceptional attention to detail - Excellent organizational, verbal and written communication skills **OrthoConnecticut,** delivering exceptional care and real results has always been our mission, though we did things a little differently when we opened our doors in 1954. Today, we provide orthopedic care in a new state-of-the-art Musculoskeletal Center of Excellence, in which we provide the full spectrum of high-quality services under one roof. Now we can diagnose and treat the complete range of musculoskeletal issues for all ages in one easily accessible location with minimal wait time and a more efficient patient experience. One thing that hasn't changed since in 1954: our commitment to you **OrthoConnecticut is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.** *The above statement reflects the general duties considered necessary to describe the principal functions of the job as identified and shall not be considered as a detailed description of all the work requirements that may be inherent in the job.*