Full-time, Precertification Specialist

Full-time, Precertification Specialist

  • Competitive Compensation & Benefits
  • Collaborative & Supportive Company Culture
  • Primarily Telecommuting Position
  • Portland-Clackamas, OR – Business Location

*Qualified candidates must permanently reside either in Oregon, Washington, Arizona, or Nevada.

Are you seeking a rewarding career opportunity where your professional talents will be recognized, utilized, and appreciated? If so, we encourage you to apply to our opening!

Innovative Care Management is seeking an experienced Precertification Specialist to join our growing and dynamic team to provide customer service for precertification in a primarily telecommuting organization. The right candidate will have a strong working knowledge of medical terminology and possess strong customer service skills, as well as the ability to work remotely and to openly communicate and collaborate with all levels of the organization. A successful candidate will also possess strong computer skills and general comfort navigating various digital platforms to ensure success during remote training with limited in person interactions with team members due to current health and safety restrictions. ICM has been providing telecommuting precertification/preauthorization opportunities for over 10 years and is committed to maintaining a strong telecommuting model even when the current public health crisis is resolved.

This is a remote position, but we are only looking for candidates that reside in Oregon, Washington, Arizona, or Nevada.

Covid Considerarions: ICM is committed to ensuring the health & safety of our employees. Employees primarily work remotely. In-office staff is limited. Vaccination is strongly encouraged; masks are mandatory when working near others. There are no in-person customers.

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Who We Are – What We Embrace:

Innovative Care Management is an equal opportunity employer. As an organization, we fully embrace diversity and inclusion. We believe and uphold that equality, diversity, and inclusion are woven into every level of our business. As a team, we continue to build a company culture that respects, empowers, and encourages our employees, while at the same time elevating the diverse and unique contributions they make. We embrace and celebrate these contributions as they inspire innovation and our ability to connect, empathize, and care for our patients as well as the diverse communities we support and serve.

Position Overview:

Under the general direction of the Manager, Precertification Programs, the Precertification Specialist position has overall responsibility for providing accurate and complete data input and application of non-clinical scripted criteria for precertification requests and providing excellent customer service. This position requires extensive use of the telephone (approximately 60% of the work week), extended sitting and long duration in front of a computer screen. Must be able to stay focused and engaged.

Specific Position Requirements and Responsibilities:

  • Answer calls from physician offices, hospitals, and patients using exemplary customer service skills.
  • Accurately enter required information via phone, fax or email (non-clinical and structured clinical data) into computer database.
  • Review structured clinical data, matching it against specified medical terms and diagnoses or procedure codes (without the need for interpretation) and follow established procedures for authorizing request or referring request for further review.
  • Maintain patient confidentiality as defined by state, federal and company regulations. Responsible for answering a high volume of incoming calls to our busy phone lines.

Schedule:

  • 8 hour shift.
  • Monday-Friday 8:00 am-5:00 pm Pacific Time.
  • No evenings or weekends.

General Employee Requirements and Responsibilities:

  • Previous experience in a medical office setting or working in precertification support position.
  • Strong understanding of medical terminology.
  • Strong time management, organization, attention to detail skills/abilities.
  • Ability to problem solve/resolve emotionally charged situations or circumstances.
  • Ability to work in a fully remote business setting without distraction or interruption.
  • Strong oral and written communication skills — specifically telephone skills
  • This is a work-from-home role performed almost exclusively from your home office with occasional in-person meetings and training when the current public health situation is resolved. It’s important to have a private workspace free of distractions and responsibilities (pets, family, loud noises, etc.) during scheduled hours to set you up for success. We’ll provide all necessary computer equipment and a monthly monetary stipend for internet service.
  • You’ll need to provide internet service with a direct connection to a cable or fiber modem. Cellular and satellite connections are not acceptable. An internet speed test will be completed during the interview stage.

    *All remote workers will be required to adhere to ICM’s Telecommuter Policy.

    Work Experience, Qualifications, Additional Skill and Abilities, and Professional Competencies:

    Experience:

    • Insurance verification: 1 year (Preferred)
    • Medical billing: 1 year (Preferred)

    Education:

    • High School Diploma or GED, required.
    • Two years of college, preferred.

    Work and Physical Conditions:

    • Ability to sit or stand for 8 hours per day.
    • Ability to wear a headset, dial, answer, and talk on a telephone for 6-8 hours per day.
    • Ability to sit or stand in front of a computer screen and type on a keyboard 8 hours per day.
    • ICM is an alcohol and drug-free workplace and an EEO Employer. Offers are contingent on successful completion of drug and background screenings.

    Salary and Benefits:

    • $20.00 per hour
    • 401(k) matching
    • Dental insurance
    • Disability insurance
    • Employee assistance program
    • Flexible spending account
    • Health insurance
    • Health savings account
    • Life insurance
    • Paid time off
    • Vision insurance
    • Work from home

    To apply:

    Please send us a copy of your resume and cover letter to: jobs@innovativecare.com. In your cover letter, please let us know why you feel your credentials are a good match for this position within our organization.


    Mailing Address:

    Innovative Care Management, Inc.
    PO BOX 22386
    Portland, OR 97269