Precertification Coordinator

Hughston Clinic

  • Nashville, TN
  • Permanent
  • Full-time
  • 30 days ago
Position Goal: Complete the precertification and prior authorization process by calling insurance companies, adjusters, and patients. Communicate the approval or denial of surgeries and/or tests effectively to physicians, physicians’ staff, and patients.
Position Responsibilities:
  • Responsible for obtaining precertification and prior authorization for patients scheduled for a surgical procedure and/or tests as ordered by physician
  • Responsible for obtaining all necessary information required to obtain precertification or prior authorization to include clinical dictation and test results
  • Provide accurate information to insurance companies based on test results, clinical dictation, etc.
  • Verify/re-verify insurance benefits and eligibility for each scheduled surgical procedure and/or test
  • Complete precertification and prior authorization process in a timely, efficient manner with respect to urgent requests.
  • Responsible for providing coverage for front office staff
**Some travel may be required.**

Experience: One year precertification experience required. Experience in a medical setting preferred. Knowledge of medical insurance, medical terminology, and computer skills.
Education: High School Diploma or equivalent required.
Special Qualifications: Must be able to work independently and have a working knowledge of HIPAA. Must have valid driver's license and satisfactory motor vehicle record (MVR).

The Hughston Clinic, The Hughston Foundation, The Hughston Surgical Center, Hughston Clinic Orthopaedics, Hughston Medical, and Jack Hughston Memorial Hospital participate in E-Verify. This company is an equal opportunity employer that recruits and hires qualified candidates without regard to race, religion, color, sex, sexual orientation, gender identity, age, national origin, ancestry, citizenship, disability, or protected veteran status. This company is a VEVRAA Federal Contractor.