Cuyahoga Falls, Ohio, United States · On-site
Surgical Services Precertification Specialist Join Our Team! At Davis Eye Center, our mission is to improve the lives of our patients through exceptional vision care. We're looking for a detail-oriented, organized, and p…
Skills: Insurance Prior Authorization, Insurance Verification, Medical Billing, Healthcare Administration, Medical Terminology
Cuyahoga Falls, Ohio, United States • On-site
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Secure insurance authorizations and precertifications for surgical procedures while verifying patient benefits and eligibility. Coordinate with surgeons, payers, and patients to ensure all approvals are obtained and documented in the electronic medical record.
Requires a high school diploma or equivalent, with an associate degree and experience in medical billing or insurance verification preferred. Candidates should be proficient in medical terminology, CPT, and ICD-10 coding.
At Davis Eye Center, our mission is to improve the lives of our patients through exceptional vision care. We're looking for a detail-oriented, organized, and patient-focused Surgical Services Precertification Specialist to join our growing team. In this role, you'll play a vital part in ensuring our patients receive timely surgical care by securing insurance authorizations and coordinating with providers, payers, and internal teams.
If you enjoy working behind the scenes to support outstanding patient care while collaborating with a dedicated surgical services team, we'd love to hear from you.
Obtain insurance prior authorizations and precertifications for surgical procedures.
Verify insurance benefits, eligibility, and coverage requirements.
Review clinical documentation to ensure authorization requirements are met.
Communicate with insurance carriers regarding authorization status and appeals.
Coordinate with surgeons, surgery schedulers, clinics, and patients to ensure all required approvals are obtained prior to surgery.
Maintain accurate documentation within the electronic medical record and other systems.
Monitor authorization expiration dates and manage renewals when necessary.
Resolve authorization denials and assist with appeals as appropriate.
Stay current on payer guidelines, authorization requirements, and regulatory changes.
Provide exceptional customer service while maintaining patient confidentiality and HIPAA compliance.
High school diploma or equivalent required; associate degree preferred.
Previous experience with insurance verification, prior authorizations, medical billing, or healthcare administration preferred.
Knowledge of medical terminology, CPT, ICD-10, and insurance processes preferred.
Strong attention to detail and excellent organizational skills.
Ability to prioritize multiple tasks in a fast-paced environment.
Excellent verbal and written communication skills.
Proficiency with electronic medical records and Microsoft Office applications.
Ability to work independently while collaborating effectively with cross-functional teams.
Physical Activity: Standing, Walking, Stooping, Grasping, Typing, and Manual dexterity. The worker is required to have visual and verbal acuity to determine the accuracy, neatness, and thoroughness of the work assigned.
Physical Requirements: Must be able to lift up to 15 pounds on a regular basis from floor to waist, 5 pounds from waist to shoulder, and 5 pounds from shoulder to overhead.
Every successful surgery begins long before the patient enters the operating room. As a Surgical Services Precertification Specialist, you'll help ensure our patients receive seamless, timely care while supporting our physicians and surgical teams every step of the way.
Offices: 789 Graham Rd, Cuyahoga Falls, Ohio 44221-1045, US
View all jobs at Davis Eye CenterOffices: 789 Graham Rd, Cuyahoga Falls, Ohio 44221-1045, US
View all jobs at Davis Eye Center