PreServices - Precertification at FirstHealth of the Carolinas, Inc.

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FirstHealth of the Carolinas is a nationally recognized health care system in central North Carolina with headquarters in Pinehurst, N.C. FirstHealth of the Carolinas has been nationally recognized as a top 150 place to work in health care by Becker's Healthcare for two consecutive years. We offer a competitive benefits package including membership to our fitness centers.

The Preservices – Precertification Coordinator is responsible for verifying insurance precertification requirements by accessing payer websites or contacting insurance providers directly. This verification is conducted in alignment with hospital contracts, payer guidelines, and applicable CPT codes for both scheduled and unscheduled services. The Coordinator ensures that all necessary actions are completed within established timeframes.

Additional responsibilities may include initiating authorization requests and verifying patient benefits.

This role may also require the Coordinator to float across various departments or locations as needed, demonstrating adaptability in support of staffing needs or fluctuations in patient volume. Floating assignments may encompass outpatient diagnostic imaging, surgical procedures, sleep studies, and the management of related denials.

As time allows, the Coordinator may contribute to team development by training new or existing staff and offering support in other operational areas based on departmental workload demands.

• Verify precertifications obtained from internal and external providers
• Initiate authorizations
• Verify benefits for service being provided
• Float across various departments or locations as needed, demonstrating adaptability in support of staffing needs or fluctuations in patient volume.

• Completion of High School or the equivalent
• Knowledge of medical terminology required
• Basic knowledge of computers required
• Previous healthcare or medical office experience required
• Strong communication and customer service skills required.
• Ability to work independently.
• Able to perform several simultaneous tasks in an organized manner.
• Ability to process information quickly and accurately while in a stressful environment.
• Must be able to type 35 to 40 wpm.

FirstHealth values diversity, equity, and inclusion, and works to create a culture of excellence in which all team members feel valued, connected, treated fairly and safe, and where differences are both respected and supported.