Member Certification Specialist coordinates the certification and credentialing programs of a professional or membership organization. Participates in the development of standards and the creation of testing materials. Being a Member Certification Specialist maintains and monitors a test scheduling system or database. Organizes resources to implement testing schedules and sessions, including locations, testers, technology, and materials. Additionally, Member Certification Specialist assists members with information about programs and resolves any issues with the process. Interfaces with and monitors outside testing providers. May require a bachelor's degree. Typically reports to a manager. The Member Certification Specialist occasionally directed in several aspects of the work. Gaining exposure to some of the complex tasks within the job function. To be a Member Certification Specialist typically requires 2-4 years of related experience. (Copyright 2024 Salary.com)
Responsible for collecting and entering complete and accurate demographic and insurance information prior to the patient’s arrival. Verifying that the pre-certification requirements of the insurance companies have been met. Verifying the benefits coverage and quantifying the patient liability portion. Contacting the patient the day before arrival to remind them of the appointment, set the expectation for payment, and answer any questions the patient may have.
FLSA: Non-exempt
EEO: □ 01 Officials and Managers □ 02 Professionals □ 03 Technicians □ 04 Sales Workers X 05 Administrative Support Workers □ 06 Craft Workers □ 07 Operatives □ 08 Laborers and Helpers □ 09 Service Workers
Minimum Education
X High school diploma or equivalent X Required
Required Skills
Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action.
Certifications:
X HFMA’s Certified Patient Account Representative (CPAR) designation- preferred
Minimum Work Experience
Minimum one (1) year in customer service focused environment.
Computer, data entry experience.
Familiar with Third Party Payers Utilization Management Requirements for Outpatient Procedures.
Must possess an understanding of Medical Terminology and diagnostic procedures.
Previous scheduling or medical diagnostic department experience