Member Certification Manager jobs in Baton Rouge, LA

About BROC:

At the Baton Rouge Orthopedic Clinic our goal is to provide a seamless continuum of health care services to maximize patients’ outcomes and convenience. We offer an organized and coordinated continuum to provide better and timelier feedback between the patient, physician, and ancillary services provider. Our main campus is located on Bluebonnet, but we have various clinics and therapies across the state of Louisiana as well as the BROC foundation that supports local schools and athletic programs by providing services throughout various communities.

Summary:

The position is located in the business office and reports directly to the Business Office Supervisor for all matters, including job duties, performance evaluations, approval of leave, and for other assignments as deemed necessary for the benefit of the Baton Rouge Orthopaedic Clinic (BROC).This positions is responsible for obtaining and documenting pre-certs for surgeries, diagnostic testing, injections, and other services in a timely and efficient manner.

Duties:

• Obtains and documents authorization for all procedures that require pre-certs including surgeries, diagnostic testing, injections, and other services.
• Verifies insurance coverage and benefits when necessary.
• Performs other related duties as assigned and serves in whatever other capacity deemed necessary for successful completion of the mission and goals of BROC.
• Maintain neat and organized work area. Report safety issues to the Billing Supervisor or Risk Management/Safety Officer immediately.
• Work efficiently and manage time wisely. Assist other employees when all duties are complete or as dictated by significant need.
• Communicate any problems, difficulties, or concerns regarding job duties to the Billing Supervisor or CEO.
• Perform all duties consistently and without significant error.
• Meet all deadlines and timeframes for completion of assignments.
• Represent BROC in a professional manner at all times. Demonstrate outstanding ability to interact positively with physicians, staff, and “external” customers (patients, family members, vender representatives, home health etc.). Exhibit good communication skills with physicians, patients, supervisors, and co-workers at all times.

Qualifications:

• High school diploma or equivalent.
• Ability to learn electronic medical records and billing systems.
• Prior experience in a pre-cert Representative position preferred.
• Knowledge of and experience with CPT and ICD-9 coding.
• Able to pass a drug screening