Job description

It’s the people that make the difference. Are you ready to make your impact?

Midwest Orthopaedics at Rush is nationally recognized as a leader in comprehensive orthopedic services. The Orthopedic Program at Rush University Medical Center is ranked 5th in Orthopedics by U.S. News and World Report. Founded in 2003, MOR is comprised of internationally-renowned Orthopedic and Spine surgeons who pioneer the latest advances in technology and surgical techniques to improve the lives and activity levels of patients around the world. MOR doctors are the official team physicians for the Chicago White Sox, Chicago Bulls, Chicago Fire Soccer Club and DePaul University Athletics.

Ready to join in? We are looking for a full-time Precertification Coordinator to be based at the corporate office near Oak Brook, IL. This position will be Monday through Friday 8am - 4:30pm. This opportunity will be remote with training provided remotely as well.

Responsibilities

• Responsible for obtaining prior approval/precertification from patient’ insurance company for surgical, MRI, PT/OT, DME and any other services.
• Verifies patient insurance information utilizing the RealMed system.
• Obtains prior approval for services via telephone, facsimile or internet.
• Verifies in-network and out-of-network coverage levels for services. If an out-of-network service follows out-of-network protocols and coordinates services with hospital(s). Refers patients with out-of-network coverage to Financial Coordinator to discuss payment options.
• Coordinates all documentation required for precertification of services including, but not limited to the medical record, pre-operative reports, and Letters of Medical necessity. Is familiar with the general surgical procedures performed by each physician.
• Requests assistance from manager or physician office if additional clinical information is required. Requests necessary documentation from each physician.
• Notifies physician office and/or patient when services are not approved. Knows process and protocols for appealing precertification decisions.
• Keeps records of phone calls. Notes name of contact, phone number and any required reference numbers.
• Contacts insurance companies and third party administrators in a timely fashion. Is able to organize and prioritize work-flow based on the needs of each physician office.
• Works well with and responds promptly to requests by Physicians, physician secretaries and other staff.
• Utilizes professional telephone conduct at all times.
• Stays abreast of and complies with all state and federal laws including HIPAA, ADA, OSHA, and FLSA.
• Understands that the mission of Midwest Orthopaedics at RUSH is to meet patient needs and provide the patient with highest level of medical care.
• Adapts to change in a positive and professional manner.
• Answers patients' questions regarding statements and insurance coverage.
• Other duties may be assigned.

Education and/or Experience

• High school diploma or general education degree (GED)
• Minimum of one year work experience, preferably in a medical office setting

Our employees make the difference in our patients’ lives, and we value their contributions. Midwest Orthopaedics at Rush offers a comprehensive compensation and benefits package and an opportunity to grow and develop your career with an industry leader. Come see what we’re all about. Equal Opportunity Employer.

Job Type: Full-time

Pay: $18.72 - $22.54 per hour

Benefits:

• 401(k)
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Referral program
• Tuition reimbursement
• Vision insurance

Schedule:

• Monday to Friday

Application Question(s):

• Please provide your salary requirements. If you are open, please provide a range.

Experience:

• Medical office: 1 year (Preferred)
• Precertification: 1 year (Preferred)

Work Location: On the road

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