You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.
Job Summary
Our client is seeking a dedicated Pre-Certification Specialist to manage the authorization process for crucial medical procedures. In this role, you will be responsible for reviewing physician orders, verifying insurance coverage, and securing necessary authorizations for treatments such as spinal cord stimulators and surgical procedures. This involves meticulously reading medical policies, interacting with insurance companies, and effectively utilizing various computer systems and web portals.
Key Responsibilities
- Process orders for medical procedures, including advanced treatments like spinal cord stimulators and surgeries.
- Collaborate with insurance providers to confirm coverage and obtain pre-certifications and authorizations.
- Interpret medical policies to determine authorization requirements and ensure compliance.
- Communicate directly with insurance companies for authorization updates and inquiries.
- Navigate and utilize diverse computer systems and web portals for insurance-related tasks.
Qualifications
- Prior authorization or pre-certification experience.
- Ability to read and interpret medical policies.
- Strong attention to detail.
- Proficiency in using computer systems and insurance web portals.
Experience
- 3-6 months of experience with medical terminology, including basic insurance, diagnosis, and CPT codes.
- Experience in prior authorization or pre-certification is preferred.
- Candidates with a medical assistant background seeking to transition into pre-certification are encouraged to apply.
Skills
- Medical Terminology (basic insurance, diagnosis, CPT codes).
- Exceptional attention to detail.
- Proficiency with computer systems and insurance web portals.
Additional Requirements
Work schedule is Monday to Friday, typically 8:00 AM or 8:30 AM to 4:30 PM, with a 30-minute unpaid lunch. A 9:00 AM start time may be accommodated if needed. Training will follow the normal schedule.
Benefits
- Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
- Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
- 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
- Short Term Disability Insurance.
- Term Life Insurance Plan.
*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).
Medix Overview:
With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.
Any required state or Joint Commission training is compensated at the state or local minimum wage rate.
*As a job position within our Revenue Cycle division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, handling financial and other payment data, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.
