Precertification Billing Lead

Ohio ENT & Allergy Physicians • Columbus, OH

2d

About The Position

At Ohio ENT & Allergy Physicians we are dedicated to providing exceptional healthcare services to our community. We are looking for a motivated Precertification Billing Lead to join our dynamic billing department.

We offer a competitive salary and benefits package, as well as opportunities for growth and advancement within our organization.
Looking for a better work/life balance? Our career opportunities have Monday-Fridays work schedules.

Summary of Duties: The Precertification Billing Lead is responsible for overseeing the precertification process, ensuring compliance with insurance guidelines, and optimizing workflows.

Requirements

• Qualified applicant should have at least 2 years experience working with insurance billing and precertification.
• Good understanding of insurance plans and medical necessity guidelines.
• Good knowledge of medical terminology & anatomy.
• Proficient with ICD-10 & CPT codes
• Qualified applicant should have previous experience with pre-certifying surgical procedures.
• Excellent oral and written communication skills required.
• Ability to establish and maintain effective working relationships with Physicians and all co-workers.
• Must be well organized and detail-oriented.

Nice To Haves

• Previous supervisor experience preferred.
• Knowledge of AthenaHealth (formerly GE-Centricity) practice management software and EHR packages beneficial but not required.

Responsibilities

• Directly supervising staff responsible for precertification and prior authorizations, ensuring timely and accurate billing.
• Monitor staff workflow to ensure precertification’s are completed in a timely manner.
• Assist with obtaining authorization via payer websites or by phone
• Follow-up on pending cases to ensure pre-cert is received prior to the scheduled procedure
• Communicate with physicians and medical staff as needed and serve as the go between for clinical staff and administration.
• Review monthly updates from individual payers for any changes in their pre-certification requirements and policies.
• Initiate appeals for denied authorizations.

Benefits

• Med/Dental/Vision
• Paid Personal Time
• Paid Holidays
• 401K
• Paid STD/LTD/Life

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 1-10 employees