This is a fully remote position.
JOB DESCRIPTION:
The Precertification Associate is a fundamental part of the patient experience and is a key contributor to the financial health of the organization. The Precert Associate coordinates all aspects of the authorization process for assigned services provided within the UVMMC Health network to assure patients are able to be scheduled timely and their financial health is secured. Associate coordinates and researches with respective clinic to assure all necessary clinical information is available and ready for submission to Payer. Associate will be expected to work with supporting departments throughout the network to assure referrals and authorizations are in place prior to the service date. This includes assuring proper registration, Insurance eligibility, benefit management, medical necessity, coding, denial research and scheduling timelines. Associate will work with providers and clinic supervisors to reschedule or escalate or cancel services where medical necessity and authorization cannot be obtained. Associate must maintain excellent customer service with all departments within the patient experience.
EDUCATION:
Associates degree in a health care field or business is required or equal experience. Coding and Medical terminology is encouraged.
EXPERIENCE:
Two years of experience in the insurance industry, medical practice billing and/or coding position, scheduling clinic appointments, utilization review.