Pre-Certification Specialist in Thomaston, Georgia at Upson Regional Medical Center

Join a winning team!

Upson Regional Medical Center is a small hospital with a BIG heart! Our employees enjoy an environment where they can take care of patients with a high degree of quality and compassion. Patients get to experience top-notch healthcare with modern technology and a team with a focus of excellence for every patient, every time.

The Pre-Certification Specialist conducts a review for medical necessity in a timely and thorough manner & enters necessary clinical data and CPT/ICD-10 codes to obtain authorization for services prior to scheduling. Utilizes critical thinking and problem-solving skills to coordinate with pre-certified staff and physician staff to obtain authorizations. Maintains clinical competency and current knowledge of payer requirements to perform pre-certification responsibilities. Demonstrates a high degree of professional skill in personal interactions both in oral and written communications, as well as being detail oriented.

Requirements: High school diploma or equivalent. Must have experience in a medical environment with health insurance verification. Prefer experience and knowledge of ICD-10 and CPT codes.