Semmes Murphey Clinic
Description:
Semmes Murphey Clinic is committed to implementing a team-based approach to provide excellence in patient care. The Precertification Specialist will ensure the timely and efficient pre-cert of SMC procedures and assist in providing continuity of quality patient care.
This will be a temporary assignment that will last from approximately 06/01/2024 to 08/01/2024.
We are looking for someone who can:
- Develop and maintain effective relationships with insurance companies, physicians and medical office staff
- Daily review of appointments scheduled by block schedulers to update the Electronic Medical Records (EMR) Precertification Tracker with Date of service/CPT codes/rendering MD/Place of service
- Review EMR Precertification Tracker and submit clinicals as needed for precertification as well as check previous EMR system for any clinicals that may need to be uploaded into new EMR system
- Update the Ambulatory Surgery Center calendar with the status of schedule blocks
- Review EMR assigned work buckets for denial letters and send patient cases to ordering Nurse of the denied precertification requests and the reason for the denial
- Communicate with block scheduling staff to be sure that all blocks are approved for the following day
- Complete reconsiderations/appeals on denials received on block requests and coordinating peer to peer needs with the ordering Nurse.
Requirements:
Minimum Requirements:
- High school diploma or equivalent
- Two (2) years' relevant experience in medical registration/admissions, precertification and/or medical insurance
Equal Opportunity Employer/Veterans/Disabled
#SMC
PI240036922
