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Pre-Cert Specialist (Insurance)

The Cardiac and Vascular Institute


Location:
Gainesville, FL 32605
Date:
02/27/2020
2020-02-272020-03-28
Categories:
  • Healthcare
The Cardiac and Vascular Institute
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Job Details

THE CARDIAC AND VASCULAR INSTITUTE is a cardiology practice in Gainesville FL.  We are passionate about providing the highest quality cardiovascular care to the people of North Central Florida. We are proud to be certified as a GREAT PLACE TO WORK .  We are seeking an INSURANCE PRE-CERTIFICATION SPECIALIST in the CLINICAL SUPPORT department of our practice.  This position is located in zip code 32605.


 


JOB TITLE:   Pre-Certification Specialist


 


GENERAL SUMMARY OF DUTIES:  Obtains insurance authorizations.


                                                          


FLSA STATUS:          Non-Exempt


 


ESSENTIAL FUNCTIONS:



  1. Pre-certify insurance and obtain authorizations for all office appointments (Office Visits, Testing, Nuclear, and PET).

  2. Submit denied authorization requests for Clinical Review or Peer-to-Peer Review

  3. Inform patients of financial obligations regarding co-pays, co-insurances, and deductibles.

  4. Secure payment arrangements as needed regarding balances on accounts.

  5. Scan all documentation regarding cardiac procedures, testing, and referrals. 



 


The job holder must demonstrate current competencies applicable to the job position.


           


EDUCATION:            High School graduate or GED


 


EXPERIENCE:          Minimum 1 year insurance experience in a health care organization or specialty practice, preferably Cardiology-based.


           


REQUIREMENTS:    Proficiency in standard EHR and Practice Management software is required.  Proficiency in medical terminology with emphasis on Cardiology.  Working knowledge of insurance guidelines and terminology as well as CPT and ICD-9 coding.  Basic knowledge of electronic medical records retrieval system, computers, and the Internet.  Perform multiple tasks and meet deadlines.  Communicate effectively, efficiently, and professionally. Knowledge of Intergy and Medical Manager systems highly preferred. 


 


KNOWLEDGE:        



  1. Knowledge of basic cardiology and medical coding terms.

  2. Knowledge of medical terminology.

  3. Knowledge of insurance industry.



 


ENVIRONMENTAL / WORKING CONDITIONS:  Work is performed in an office environment.  Frequent contact with physicians and staff as well as extensive phone contact with patients and staff at outlying facilities.  Work is stressful at times. 


 


PHYSICAL/MENTAL DEMANDS:  Work requires hand dexterity for office machine operation, stooping and bending to files and supplies, and sitting for extended periods of time.  Manual dexterity for using a calculator or computer keyboard.
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