Precertification Representative

Job Description

Job Description

Precertification Representative

Be a part of our talented and growing team!

Are you looking for a Full-Time Precertification Representative position in an office setting? At Princeton Medical Group, we are looking for dedicated individuals to join our dynamic team to support our wide variety of medical specialties!

About Us:

Princeton Medical Group, P.A. We are a private medical practice with over 30 providers and 8 medical specialties. Our mission has always been to deliver excellent medical care with compassion.

PMG's Comprehensive Benefit Plan:

• Personal medical and dental insurance
• 401k and profit-sharing plan
• Life insurance
• 3 weeks' vacation time
• 40 hours of paid sick leave
• Employee Assistance Program

Precertification Representative Responsibilities

As an important part of our clinical operations, your duties will include:

• Obtain precertification's for testing/procedures.
• Communicate with nursing staff all necessary information concerning precertification for patients.
• Stay actively abreast of changes in insurance company requirements and guidelines and relay changes as they occur to staff.
• Use manual and computerized systems to obtain precertification's.
• Track appeals for denied requests to insurance companies.
• Complete follow up tasks related to active and pending reviews
• Coordinate peer to peer sessions as needed.
• Establish and maintain logs to ensure historical patient and office activities are available for review by doctors or nursing staff.
• Adhere to strict confidentiality guidelines.

Precertification Representative Requirements:

• Previous precertification experience
• Excellent customer service skills for dealing with both internal and external customers
• Knowledge of insurances and precertification processes
• Knowledge of medical terminology and the ability to interpret medical charts
• 1 year of experience with ICD-10 billing processes (Preferred)

Schedule:

• Monday to Friday 8:30 AM - 5:00 PM, flexibility is necessary as this schedule is subject to change.
• Overtime as required

Medical Specialties Providing Support For:

• Pulmonology
• Gastroenterology
• Primary Care
• Cardiology
• Rheumatology
• Endocrinology
• Oncology/Hematology
• Dermatology

Healthcare Setting:

• Medical Office
• Outpatient
• In-person

Job Locations:

• Princeton, NJ

Pre-employment drug screen is required

Pre-employment professional reference check is required

PMG is an equal employment opportunities ( EEO ) to all employees and applicants for employment without regard to, and does not discriminate on the basis of, race, color, religion, creed, gender/sex, sexual orientation, gender identity and expression (including transgender status), national origin, ancestry, citizenship status, age, disability, genetic information, marital status, pregnancy, military status, veteran status, or any other characteristic protected by applicable federal, state, and local laws.