EMC Job Opportunities

"Work and live in a community that appreciates you. Practice your profession where it matters. Lower cost of living, higher quality of life. Emanuel Medical Center wants you!"

Emanuel Medical Center, P.O. Box 879, 117 Kite Road, Swainsboro, GA 30401
Fax: 478-289-1385 Email: humanresources@remove-thisemanuelmedical.org

QUALIFIED CANDIDATES’ APPLICATIONS WILL BE FORWARDED TO THE APPROPRIATE MANAGER. APPLICATIONS SUBMITTED FOR POSITIONS OTHER THAN THOSE POSTED WILL NOT BE CONSIDERED.

520 Precert Manager

Job Type
Fulltime
Contract Type
Contract
Job Description

Pre-certification Manager

 

The Pre-Certification Manager  ensures the effective and efficient use of services, monitors appropriateness and medical necessity and provides necessary information for authorization of services for physician practices.  The precert manager oversees the daily operation of the precert office and staff. 

 

Job Requirements

Duties and Responsibilities:

Responsible for the daily operation of the precert office.

Responsible for tracking, obtaining and communicating pre-authorizations/pre-certifications as needed per insurance company requirements in a timely manner.

 

Responsible for obtaining complete and accurate insurance information, benefit verifications, accurately interpreting benefit plans and investigating pertinent details.

 

Track a significant amount of data and information, preparing and producing meaningful reports and information.

 

Assists with the effective management of all incoming procedure pre-certification needs and effective follow-through of the pre-certifications.

 

Assist in the development, organization and maintenance of role specific documents, policies and tools.

 

Provides direct support for physicians when dealing with pre-certification issues.

 

Provides all authorization and pre-certifications to physician and physician staff in a timely manner.

 

Communicates with patients and providers about authorization denials, appeals or other issues.

 

Communicates as needed with physicians/clinicians and other staff about any patient concerns/issues related to scheduling.

 

Facilitates communication as needed between patients, insurance carriers, clinics physicians and referring physicians.