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Pre-Certification Specialist

Full Time

Job Summary

 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. 

Minimum Qualifications