PRE-CERT CLERK

Communicates with nursing staff and patients' insurance company to obtain authorization/pre-certifications for outpatient/in-patient procedures and medication infusions/injections as ordered by physician. Pleasant, courteous disposition with the ability to communicate effectively with insurance representatives as well as patients, employees and physicians. Professional in conduct and appearance.

1. Obtains pre-certification form for outpatient and/or in-patient
procedure from nursing staff with patients' demographic, diagnosis,
type of procedure and insurance information.
2. Contacts patients' insurance companies by phone or use of internet
to acquire the pre-cert number.
3. Documents on the pre-cert form the date, person spoken to and
authorized pre-cert number.
4. Completes information in the EHR "Incoming Referrals" tab for
attachment to claim.
5. Completes referral requests and files referral forms.
6. Keeps a record on each contact with insurance companies by
computer and file notes.
7. Faxes pre-cert information to hospital admissions as needed.
8. Answers telephone identifying self.
9. Returns phone calls in timely manner.
10.Floats to other areas as needed.
11.Follows approved Electronic Medical Record Security standards as
outlined by Information Systems department.
12.Keeps workstation neat and clean.
13.Completes OSHA and Fire Safety training annually.

1. High school education or equivalent.
2. Computer knowledge.
3. Good interpersonal skills.