Member Certification Specialist jobs in Connecticut

Description

GENERAL STATEMENT OF DUTIES:

Responsibilities include pre-certification/authorization of all diagnostic testing and in-office injections, as well asproviding coverage for secretaries when needed.

Schedule: Monday-Friday 8am-5pm (no weekends)

Benefits:

• 401(k) matching profit sharing
• Health/Dental/Vision Insurance
• FSA/HSA options
• Life insurance/AD&D/STD/LTD
• Paid time off
• Employee Discount Program
• Wellness Program

RESPONSIBILITIES / WORK REQUIREMENTS:

Pre-Certification:

• Verifies insurance coverage to obtain precertification/authorization for all radiology tests, specialty injections, and other services as needed.
• Maintains contact with testing facilities regarding scheduled tests/STAT orders
• Faxes all pre-authorized services to facilities, and makes any changes, as needed.
• Enters benefits and precertification/authorization into EMR system.
• Follows up daily on all pending orders, obtaining office notes if needed for insurance companies

Secretary Coverage:

• Ensuring an excellent patient experience from entry to departure
• Properly greeting each patient with a professional and pleasant attitude, check them in and out, and escort them to the exam room, if needed
• Effectively communicating with patients when they make inquiries, by phone or at the office
• Screening and referring incoming phone calls and visitors to ensure accurate, timely, and positive communication, facilitation
• Demonstrating regard for the dignity and respect of all patients, family members, staff, and visitors
• Maintaining proper attendance and punctuality to ensure the office is operated in an efficient and cost-effective manner
• Respecting and understanding the patient's right to treatment and right to involvement in treatment decisions
• Understanding and adhering to all HIPAA regulations regarding patient confidentiality and recordkeeping (written acknowledgement required)

Qualifications

REQUIRED KNOWLEDGE, SKILLS AND ABILITIES:

• High school graduation or GED; post graduate degree preferred
• At least one year of work experience in a medical office setting
• Knowledge of medical office procedures and insurance verification
• Familiar or experience with ICD 10/CPT Code
• Ability to demonstrate a mature, dependable, and responsible approach when interacting with patients, physicians, co-workers, and additional outside sources
• Proactive self-starter
• Understands referral requirements of major third party payers
• Ability to multi-task, prioritize and exceptional attention to detail
• Excellent organizational, verbal and written communication skills
• Bilingual (preferably English and Spanish speaking)

OrthoConnecticut, delivering exceptional care and real results has always been our mission, though we did things a little differently when we opened our doors in 1954. Today, we provide orthopedic care in a new state-of-the-art Musculoskeletal Center of Excellence, in which we provide the full spectrum of high-quality services under one roof. Now we can diagnose and treat the complete range of musculoskeletal issues for all ages in one easily accessible location with minimal wait time and a more efficient patient experience. One thing that hasn't changed since in 1954: our commitment to you

OrthoConnecticut is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

The above statement reflects the general duties considered necessary to describe the principal functions of the job as identified and shall not be considered as a detailed description of all the work requirements that may be inherent in the job.