Insurance Precertification Coordinator

About Us: Milford Regional Medical Center is a full-service, community and regional teaching hospital located in Milford, Mass. and serves patients from more than 20 towns in Central Massachusetts.

The 149-bed medical center is a nonprofit, acute-care facility, where more than 300 primary care and specialty physicians are committed to providing exceptional healthcare services to our community with dignity, compassion and respect. Statement of Purpose:# Under the general supervision of the Supervisor of Admitting and the Registration Manager, establishes pre-certification and authorization for all# Admissions and Surgical Day patients, which is necessary for proper reimbursement from insurance companies to Milford Regional Hospital. Qualifications: Education: High School Diploma or GED# 2 years medical prior authorization experience preferred# 2 years

experience in a medical related field required Experience:

Knowledge of procedure authorization and its direct impact on the practice#s revenue cycle Understanding of payer medical policy guidelines while utilizing these guidelines to manage authorizations effectively# Basic understanding of human anatomy, specifically musculoskeletal# Proficient use of CPT and ICD-10 codes# Excellent computer skills including Excel, Word, and Internet use# Detail oriented with above-average organizational skills# Plans and prioritizes to meet deadlines# Excellent customer service skills; communicates clearly and effectively# Ability to multitask and remain focused while managing a high-volume, time-sensitive workload# Under general supervision, performs work in accordance with established policies and procedures referring to the supervisor and department manuals for assistance in cases of non-routine patient admittance.

About Us:

Milford Regional Medical Center is a full-service, community and regional teaching hospital located in Milford, Mass. and serves patients from more than 20 towns in Central Massachusetts.

The 149-bed medical center is a nonprofit, acute-care facility, where more than 300 primary care and specialty physicians are committed to providing exceptional healthcare services to our community with dignity, compassion and respect.

Statement of Purpose:

Under the general supervision of the Supervisor of Admitting and the Registration Manager, establishes pre-certification and authorization for all

Admissions and Surgical Day patients, which is necessary for proper reimbursement from insurance companies to Milford Regional Hospital.

Qualifications:

Education:

High School Diploma or GED

2 years medical prior authorization experience preferred

2 years' experience in a medical related field required

Experience:

Knowledge of procedure authorization and its direct impact on the practice's revenue cycle

Understanding of payer medical policy guidelines while utilizing these guidelines to manage authorizations effectively

Basic understanding of human anatomy, specifically musculoskeletal

Proficient use of CPT and ICD-10 codes

Excellent computer skills including Excel, Word, and Internet use

Detail oriented with above-average organizational skills

Plans and prioritizes to meet deadlines

Excellent customer service skills; communicates clearly and effectively

Ability to multitask and remain focused while managing a high-volume, time-sensitive workload

Under general supervision, performs work in accordance with established policies and procedures referring to the supervisor and department manuals for assistance in cases of non-routine patient admittance.