Pre-Certification Specialist

Welcome to Billings Clinic, where we strive to provide exceptional healthcare services to our patients and community. We are currently seeking a highly motivated and detail-oriented individual to join our team as a Pre-Certification Specialist. In this role, you will play a crucial part in ensuring that our patients receive the necessary insurance pre-approvals for their medical procedures. Our ideal candidate will have a strong understanding of insurance pre-certification processes and a passion for helping patients navigate the complexities of healthcare coverage. If you are a team player with excellent communication skills and a commitment to providing excellent customer service, we would love to hear from you.

1. Review and verify insurance coverage for scheduled procedures to ensure proper pre-certification.
2. Communicate with insurance companies and providers to obtain necessary pre-approvals for medical procedures.
3. Maintain accurate and detailed records of insurance pre-certification processes.
4. Collaborate with healthcare providers and billing staff to resolve any pre-certification issues or denials.
5. Educate patients on their insurance coverage and any potential out-of-pocket costs.
6. Monitor and track pre-certification timelines to ensure timely completion.
7. Stay up-to-date on insurance industry changes and regulations to ensure compliance.
8. Work closely with the billing team to ensure accurate and timely submission of pre-certification information.
9. Provide exceptional customer service to patients by addressing any questions or concerns related to insurance coverage.
10. Participate in team meetings and contribute ideas for process improvement.
11. Maintain confidentiality of patient information and adhere to HIPAA regulations.
12. Collaborate with other departments to ensure a seamless patient experience.
13. Maintain a positive and professional attitude while representing the organization.
14. Prioritize and manage multiple tasks to meet deadlines.
15. Continuously seek opportunities for growth and development within the role.

According to JobzMall, the average salary range for a Pre-Certification Specialist in Billings, MT, USA is $34,000-$63,000 per year. This may vary depending on the specific company, level of experience, and other factors.

Billings Clinic is a health care center in Billings, Montana. Their primary and specialty care clinics are located at Billings Clinic downtown, Billings Clinic Heights, and Billings Clinic West, as well as in Bozeman, Columbus, Miles City, Montana, Red Lodge, and Cody, Wyoming.