Employment Status: Full-Time, PRN
Department: PATIENT BUSINESS SERVICES
The Pre-Certification Specialist will be responsible for having all authorizations necessary for approval of services for patients who are scheduled for services at MMC or NWCC. Specialist able to discuss insurance coverage and potential financial liability with patients. This individual will also act as a patient advocate by being the liaison between the patient, doctors, hospital, and insurance company.
Responsibilities and Duties:
- Verifies insurance coverage with clinic or patient.
- Contacts insurance company to pre-certify procedure (as necessary) and determine patient’s liability.
- Discusses patient’s liability with patient and coordinates a payment schedule.
- Answers patient’s questions, and serves as an advocate by offering assistance in communications with the doctor, insurance company, and/or hospital.
- Does follow-up with non-scheduled admissions following same procedure as above.
- Completes authorization process in EPIC
- Inputs demographics into the computer system.
- Secures necessary signatures.
- Updates patients chart/record with required documents.
- May act as a relief for patient financial services, in times of emergency.
- Treats each patient as a valued customer.
- Shows compassion and consideration when interacting with customers.
- Is pleasant and courteous.
- Maintains a professional image and attitude.
Qualifications and Skills:
- Must be able to read, write, and speak the English language.
- Must be able to key accurately at a minimum of 40 wpm.
- Must be competent with Microsoft office applications.
- Must be able to become competent with department specific software within 30 days of hire.
- Must demonstrate excellent communication skills.
- Must be able to remain calm and level headed in stressful situations.
- Must be able to understand medical terminology and insurance laws/guidelines.
- Must be able to be flexible in work schedule.
- Must be able to work with many interruptions.
- Must be able to demonstrate effective customer service skills and to remain calm and level headed in stressful situations.
- Must demonstrate excellent communication skills in order to effectively explain insurance issues, etc. to patients.
Education / Licensure / Certification Qualifications:
- Completion of a two-year post high school degree in office support services or equivalent job experience.
- Must have at least 3 years’ experience in healthcare billing or precertification.
- 8- hour shifts
Benefits and Salary:
MMC offers employees a competitive benefits package that includes:
*eligibility criteria must be met to participate in insurance plans. Not all employees may be eligible.
403 (b) Retirement Savings Plan
All employees are eligible to participate in the savings plan. Through payroll deductions, you can elect to contribute pre-tax and/or post-tax basis towards your retirement. We offer matching contributions for eligible employees.
Paid Time Off
MMC employees receive generous time off for vacations, illness and other personal matters.
MMC is a regional medical center that serves patients from 7 counties in northwest Wisconsin and Gogebic County in Michigan. We have more than 60 full-time physicians and specialists on-staff and over 500 employees who are dedicated to providing quality care. Our charming city of Ashland, WI is located on the shores of Lake Superior near Bayfield and the 21 Apostle Islands, and boasts a strong community, historic charm, modern conveniences and abundant opportunities for outdoor recreation. Our passion and driving force is to see the people of our community live healthy, productive lives. EOE.Apply Now