Precertification Billing Lead (Columbus)

At Ohio ENT & Allergy Physicians we are dedicated to providing exceptional healthcare services to our community. We are looking for a motivated Precertification Billing Lead to join our dynamic billing department.

We offer a competitive salary and benefits package, as well as opportunities for growth and advancement within our organization.

Looking for a better work/life balance? Our career opportunities have Monday-Fridays work schedules.

Competitive Pay & Benefits: Med/Dental/Vision, Paid Personal Time, Paid Holidays, 401K, Paid STD/LTD/Life

Summary of Duties: The Precertification Billing Lead is responsible for overseeing the precertification process, ensuring compliance with insurance guidelines, and optimizing workflows.

• Directly supervising staff responsible for precertification and prior authorizations, ensuring timely and accurate billing.

• Monitor staff workflow to ensure precertification’s are completed in a timely manner.

• Assist with obtaining authorization via payer websites or by phone

• Follow-up on pending cases to ensure pre-cert is received prior to the scheduled procedure

• Communicate with physicians and medical staff as needed and serve as the go between for clinical staff and administration.

• Review monthly updates from individual payers for any changes in their pre-certification requirements and policies.

• Initiate appeals for denied authorizations.

PM20

• Qualified applicant should have at least 2 years experience working with insurance billing and precertification.

• Previous supervisor experience preferred.

• Good understanding of insurance plans and medical necessity guidelines.

• Good knowledge of medical terminology & anatomy.

• Proficient with ICD-10 & CPT codes

• Qualified applicant should have previous experience with pre-certifying surgical procedures.

• Excellent oral and written communication skills required.

• Knowledge of AthenaHealth (formerly GE-Centricity) practice management software and EHR packages beneficial but not required.

• Ability to establish and maintain effective working relationships with Physicians and all co-workers.

• Must be well organized and detail-oriented.

Education: High School Diploma

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