Insurance Precertification Coordinator in Milford, Massachusetts at Milford Regional Medical Center

About Us:

Milford Regional Medical Center is a full-service, community and regional teaching hospital located in Milford, Mass. and serves patients from more than 20 towns in Central Massachusetts. The 149-bed medical center is a nonprofit, acute-care facility, where more than 300 primary care and specialty physicians are committed to providing exceptional healthcare services to our community with dignity, compassion and respect.

Statement of Purpose:
Under the general supervision of the Supervisor of Admitting and the Registration Manager, establishes pre-certification and authorization for all
Admissions and Surgical Day patients, which is necessary for proper reimbursement from insurance companies to Milford Regional Hospital.

Qualifications:

Education:

High School Diploma or GED
2 years medical prior authorization experience preferred
2 years’ experience in a medical related field required

Experience:

Knowledge of procedure authorization and its direct impact on the practice’s revenue cycle
Understanding of payer medical policy guidelines while utilizing these guidelines to manage authorizations effectively
Basic understanding of human anatomy, specifically musculoskeletal
Proficient use of CPT and ICD-10 codes
Excellent computer skills including Excel, Word, and Internet use
Detail oriented with above-average organizational skills
Plans and prioritizes to meet deadlines
Excellent customer service skills; communicates clearly and effectively
Ability to multitask and remain focused while managing a high-volume, time-sensitive workload
Under general supervision, performs work in accordance with established policies and procedures referring to the supervisor and department manuals for assistance in cases of non-routine patient admittance.