Pre-Certification Coordinator II (Remote) - Orthopedic Surgery
Core
Completes pre-certifications and rechecks for complex orthopedic therapy and treatment plans to prevent insurance write-offs.
Role type
Pre-certification coordinator
Builds
Insurance authorizations and documentation in EPIC
Domain
Healthcare administration / Orthopedic surgery
Deliverable
dashboards & analysis
Required skills
Insurance eligibility verification, Payer policy analysis, EPIC EHR, Clinical documentation review, Denial/appeal resolution
Preferred skills
CPC certification, RHIT certification, Managed care terminology, HIPAA compliance
Technologies
EPIC, Insurance Claim Processing Software
Responsibilities
Analyze therapy and treatment plans to complete pre-certifications; Verify insurance eligibility and authorization information; Resolve denials and appeals with clinical staff and providers; Document all authorization information in EPIC.