Precertification Specialist

Deerwalk Services

Deerwalk Services Pvt. Ltd. is a wholly owned subsidiary of Deerwalk Inc. based in Lexington, Massachusetts, USA. Deerwalk is a healthcare analytics and custom software Development Company focused on delivering Big Data solutions to the healthcare industry. Deerwalk Services builds software and provides IT services for Deerwalk and its clients.

Job Information

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    Duty Station Kathmandu
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    Type of Appointment Full time
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    No. of Openings 1 opening
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    Salary 30000-50000 / Monthly
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    Job Level : Entry Level
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    Job Experience : 1+ Years
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    Job Category Admin & Management
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    Job Qualification : Bachelor
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    Posted Date : Dec 19, 2021

Job Description

The Precertification Specialist acts as liaison between payers and healthcare providers, verifying patient insurance eligibility and benefits as well as obtaining precertifications (authorizations) for all specified procedural orders. [Extensive training will be provided for this entry-level position, and candidates without any experience are also encouraged to apply.]

Responsibilities:

  • Verifies patient insurance eligibility and benefits for specified services.
  • Captures patient demographic, eligibility, and benefits information within applicable software systems.
  • Obtains and documents precertification numbers from insurance companies prior to specified services per protocol.
  • Obtains and documents referral details and referral modifications for specialty care and testing for patients with insurance plans requiring formal referral documentation.
  • Distributes organization inpatient and outpatient service lists and manifests to affiliated healthcare providers.
  • Corrects any account in which errors have occurred per assigned deadline.
  • Maintains communication among healthcare providers, insurance companies, and organization regarding status of patient eligibility, benefits, and precertifications.
  • Meets all department accuracy and productivity standards.
  • Maintains appropriate records for area(s) of responsibility.
  • Maintains confidentiality of all information in accordance with HIPAA.
  • Maintains company confidentiality.
  • Attends all regular staff meetings.
  • Participates in continuing training to keep current on area of specialty.
  • Works overtime as needed.
  • Completes additional duties and projects as assigned by management.

Required Qualification & Experience

  • Bachelor’s degree in any field
  • Computer experience including good working knowledge of the Microsoft Office Suite and internet
  • Experience with alpha-numeric data entry
  • Strong English language written and verbal communication skills
  • Strong analytical and problem-solving skills
  • Excellent organizational and time management skills
  • Ability to perform assigned tasks independently
  • Ability to prioritize and multitask to meet deadlines
  • Ability to develop productive working relationships in a team environment

How to Apply

  • Email your application and resume to career@deerwalk.com by 1st, January 2022.
  • Mention ” Precertification Specialist” in the email subject.
  • Only shortlisted candidates will be called for interviews.

Deerwalk is an equal opportunity employer and believes in creating a diverse workplace.