Pre-Certification Specialist PRN

The Pre-Certification Specialist will be responsible for verifying funding for each patient entering Central Intake and for transferring or completing pre-certification on time. Maintains accurate documentation of all contacts. Reports to and functions under the direction, instruction, and supervision of the Provider Services & Baker Act Office Supervisor.

PRN (As Needed) Employment within an inpatient / healthcare facility.

ESSENTIAL RESPONSIBILITIES:

• Verification of fund source for each new patient in Central Intake.
• Complete a transfer or a precertification as indicated by fund source.
• Maintains good documentation on all forms to reflect contacts made for authorization.
• Relays all duties completed and those that need follow-up in the email shift report for the following shift.
• Follows up on all incomplete tasks from prior shift.
• Maintains good communication with other managed care staff, as well as Central Intake and CSU regarding funding & authorization issues.
• Responds to emails regarding changes or updates in funding as soon as they are known, but no later than the end of each shift.

QUALIFICATIONS:

Associate degree from an accredited college plus three years' experience in a related field, or Bachelor's degree from an accredited college or university, plus 1 year experience in a related field. Experience can substitute for education. Needs to be able to read and write proficiently; needs to be able to utilize Microsoft Word, Excel, Outlook, PowerPoint & Avatar (EHR).

WORK ENVIRONMENT:

General office, health care setting with client contact. Most work is completed while sitting at a desk using standard office equipment. Fast-paced team approach. Multi-tasking ability requires above-average time management skills.

PHYSICAL DEMANDS:

Abilities include reaching, bending, talking, sitting, carrying, standing, grasping, fine hand coordination, hearing, reading, writing, and staying calm under stress. Must be able to reach with hands and arms, climb stairs, maintain balance, stoop, kneel, crouch, or crawl. Vision abilities required include close-up, distance, color, peripheral, depth perception, and the ability to adjust focus. Must be capable of lifting 50 pounds alone. May be required to deliver standing presentations that involve speaking and listening to the audience.