Hybrid PRECERT SPECIALIST bei SportsMED Orthopaedic Surgery & Spine Center

SportsMED Orthopaedic Surgery & Spine Center in Huntsville, AL, is seeking a Precertification Specialist to join our Billing and Insurance Team.

The Precertification Specialist reports to the Precertification Supervisor. Under indirect supervision, the Precertification Specialist performs pre-certification functions to ensure that all services requiring carrier authorizations are approved. 

The duties associated with this role include but are not limited to:

• Verify insurance benefits and coverage for upcoming procedures and surgeries.

• Obtain precertifications and authorizations from insurance carriers in a timely manner.

• Communicate with physicians, clinical staff, and patients regarding authorization statuses and insurance requirements.

• Document all communication and authorizations in the EMR system accurately.

• Track pending authorizations and follow up as needed to ensure approvals are received before scheduled services.

• Stay current with payer policies, coding guidelines, and insurance verification protocols.

• Serve as a liaison between patients and insurance providers to answer questions or resolve issues.

• Coordinate with billing and scheduling departments to ensure all procedures are cleared before the date of service.