Pre-Certification Specialist - Upson Regional Medical Center

The Pre-Certification Specialist conducts review for medical necessity in a timely and thorough manner & enters necessary clinical data and CPT/ICD-10 codes to obtain authorization for services prior to scheduling. Utilizes critical thinking and problem-solving skills to coordinate with Precert staff and physician staff to obtain authorizations. Maintains clinical competency and current knowledge of payor requirements to perform precertification responsibilities. Demonstrates a high degree of professional skill in personal interactions both in oral and written communications, as well as being detail oriented.

Requirements: High school diploma or equivalent. Must have experience in a medical environment with health insurance verification.

Prefer experience and knowledge of ICD-10 and CPT codes.

PI251663328