Job Description
Pre-certification Specialist - Primary Care
(PC)
Cynthiana, KY, United States of America
Overview
Harrison Memorial Hospital is a regional medical facility nestled in the heart of Kentucky. HMH is an independent, not-for-profit hospital, founded in 1906. HMH was recently awarded the prestigious five-star rating in the CMS (Centers for Medicare and Medicaid Services) overall hospital quality star ratings for 2023 and is proud to be recognized as one of the top performing hospitals in the nation, joining an elite group of only five hospitals in the state of Kentucky to receive this distinguished honor. HMH offers competitive pay, a wide variety of extremely affordable benefits, generous paid time off and on-site childcare.
HMH’s hometown of Cynthiana, KY, in Harrison County, displays a small-town southern charm with a strong community feel. Harrison County is the perfect place to live, work and play. It has a diverse, historic downtown equipped with shopping, eating or enjoying our many artistic murals. Cynthiana offers plenty of family entertainment options such as a bowling center, roller rink and historic movie theater offering first run movies. Cynthiana is currently building a brand-new high school, scheduled to open in 2026, and is home to a top-rated community college. Our town may be small, but the service we deliver is BIG!!
Job Skills / Requirements
Job Summary:
The Precertification Specialist is responsible for obtaining prior authorizations for all procedural orders by successfully completing the authorization process with all commercial payers.
Required Education, Skills, and/or Abilities:
- SRNA, CMA, or Coding (CCA or CPC) certification required or equivalent years of clinical care experience.
- 2 years medical prior authorization experience preferred.
- Knowledge of procedure authorization and its direct impact on the practice’s revenue cycle
- Understanding of payer medical policy guidelines while utilizing these guidelines to manage authorizations effectively
- Basic understanding of human anatomy
- Proficient use of CPT and ICD-10 codes
- Excellent computer skills including Excel, Word, and internet use
- Detail oriented with above average organizational skills
- Plan and prioritizes to meet deadlines
- Excellent customer service skills; communicates clearly and effectively
- Ability to multitask and remain focused while managing a high-volume, time sensitive workload
Education Requirements (Any)
HIGH SCHOOL DIPLOMA OR EQUIVALENT
Certification Requirements (Any)
SRNA or CMA
CCA or CPC certification
Additional Information / Benefits
Employees will be expected to comply with HMH’s vaccination policies, which include but is not limited to, compliance with “HMH COVID-19 Vaccination Requirements for Healthcare Workers” unless reasonable accommodations are needed under applicable law.
This job reports to the Department Manager
This is a Full-Time position 1st Shift, Monday - Friday 8:00am - 4:30pm.
Number of Openings for this position: 1