Pre-Certification Specialist
United Musculoskeletal Partners
**DESCRIPTION**
**RESPONSIBILITIES INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING:**
+ Verifies insurance coverage to ascertain deductible and coinsurance amounts, obtaining precertification/authorization for durable medical equipment and other services as needed.
+ Notifies patients of expected financial responsibility that will be due at the time of service.
+ Schedules pre-authorized services and follow-up office visits as needed.
+ Provides explicit instructions to patients regarding time of arrival, place of service, and documentation necessary for office visits.
+ Enters benefits and precertification/authorization into EMR system (Referral Management).
+ Coordinates with referring physician offices when necessary to pre-authorize services.
+ Coordinates with AOA business office to evaluate and resolve reimbursement issues.
+ Maintains work area in a neat and orderly manner at all times.
+ Attends scheduled staff meetings.
+ Availability to work in the office setting Monday-Friday.
+ Additional responsibilities as assigned by Director of CBO.
**REQUIREMENTS**
**EDUCATIONAL REQUIREMENTS:**
+ High School Diploma/GED or equivalent experience.
**QUALIFICATIONS AND EXPERIENCE**
+ Computer literate, with keyboard skills-working knowledge of practice management software.
+ One or more years of DME experience.
+ One or more years’ experience in insurance verification / precertification in a medical office or hospital setting preferred.
+ Knowledge of medical terminology.
+ One year or more of work experience in various areas of medical insurance preferred.
+ Knowledge of CPT and ICD-9 coding of DME.
+ Pleasant speaking voice and demeanor.
+ Neat, professional appearance.
+ Ability to perform in a highly stressful situation.
+ Ability to multitask.
+ Ability to focus and maintain direction in the tasks at hand under pressure.
+ Ability to establish effective working relationships with patients, physicians, insurance representatives and other medical support staff.
+ Background in medical terminology and orthopedics preferred.
+ Ability to analyze various medical situations for scheduling purposes
**Company:** Arlington Orthopedics Associates
**Job Type:** Full-time
**Address:** 800 Orthopedic Way, Arlington, TX, 76105
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