PreCertification Specialist 保险审核专员

1. Contacts insurance companies to determine patient’s internationalinsurance benefits. Verify patient eligibility an********-certificationrequirements through On-line verification software, email or bytelephone
2. Obtains requirements for claim submission an********-certificationprocess from insurance companies
3. Determines contract an******** eligibility for pre-cert******** priorauthorization of inpatient an******** services
4. Works with patients in securing prepayment sources or financialagreements prior to providing service
5. Maintains the pre-certification relate******** in the system toensure its accuracy
6. Verifies the coverage of benefit an******** for the payment guaranteein advance to expensive examinations for all outpatients
7. Assists patient on insurance coverage relate********
8. Responds to an******** through on patient an******** relate********
9. Conducts financial screening for all inpatients (Observat******** DaySurgery, Admission)
10. Coordinates an******** inpatient inquiries
11. Coordinates on discharge process, prepares itemize******** statementupondischarge
12. Maintains strictest confidentiality of patient information
13. Assists other office personnel in the performance of their duties asassigne******** performs relate******** as required
14. Serve as liaison with the insurance company, hospital an********.
15. May also manage appeals for services denied.
16. Assists in training new employees of the Pre-certification team.

1. Minimum education- the completion of Junior College
2. Working experience in BJU or a similar health care organization or abusiness setting desired
3. Must be flexible to work thir********
4. Additional education/experience may be substitute********experience/education
5. Excellent oral an******** English
6. Independent decision making
7. Professional telephone etiquette
8. Goo******** management skills an******** be able to prioritize
9. Must be flexible to work thir********
10. Basic computer skills
11. Must work well under pressure an******** able to work on multipletasks simultaneously.
12. Knowledge of medical terminology an******** industry preferred
13. Knowledge of clinic charg******** coding an******** billingprocedures preferred (but trainable)