Job Details
Level
Management
Job Location
UUG Corporate – Owings Mills, MD
Remote Type
Hybrid
Position Type
Full Time
Education Level
High School
Salary Range
$65,000.00 – $80,000.00 Salary/year
Job Category
Accounting
Description
Are you interested in making a difference in patient care? Learn about our unique culture of respect, growth, innovation, the best patient care, and how we give back to the community.
At United Urology Group, our employees are at the heart of our mission and have incredible opportunities to impact our patients’ lives with their urologic care.
- We foster a culture that thrives on compassion, teamwork, integrity, and diversity, all of which start with our staff!
- We deliver a cohesive approach to urologic care that provides patients with access to experienced specialists, a superb team of healthcare professionals, and the most advanced technology for patient treatments and therapies.
- We offer competitive salaries and a great work/life balance: enjoy your weekends!
- UUG offers outstanding benefits, including tuition reimbursement, health, dental, and vision insurance, corporate discounts, and much more!
United Urology Group is regarded as the leading urology network in the country. Our Urology Group Affiliates consist of Chesapeake Urology, Arizona Urology- Phoenix & Scottsdale, Arizona Urology – Tucson, Colorado Urology & Tennessee Urology.
Position Summary:
The Pre-Certification (Pre-Cert) Manager oversees the entire operation of the Pre-Cert team, which is responsible for verifying patient eligibility and benefits, obtaining a pre-cert and/or referral, and providing patient estimates for procedures.
Primary Duties & Responsibilities:
- Oversee the daily Pre-Cert schedule to ensure the vendor partner and Pre-Cert team are completing the eligibility and benefits, obtaining a Pre-Cert and/or referral, and generating patient estimates in a timely and accurate fashion.
- Ensure that all cases are completed in compliance with payer policy.
- Manage the daily workload to ensure cases are worked timely and accurately, and the distribution between the vendor partner and the UUG Pre-Cert Coordinators is appropriate.
- Acts as the lead point of contact with the vendor partner and collaborates on any outstanding cases or cases at risk to avoid patient care disruptions or revenue loss.
- Audits completed cases to ensure proper procedures are followed.
- Addresses any issues relating to incorrect patient estimates.
- Partners with the Accounts Receivable team on any denials for no Pre-Cert or referral related to cases for which the Pre-Cert team is responsible.
- Prepares and updates materials in training manual and updates the vendor partner on any new payer or procedure requirements.
- Works directly with the provider’s staff on any cases that are at risk and determines the appropriate steps to avoid patient care disruption or lost revenue.
- Maintains personal and team knowledge of payer policy, clinical criteria, and Pre-Cert requirements.
- Focuses on process improvement to maximize the efficiency and quality of Pre-Cert team.
- Participates in new procedure workflow development and creates training materials to support the process.
- Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time, with or without notice.
Qualifications
Qualifications:
- Minimum High School Diploma or GED required.
- Minimum of five (5) years Pre-Certification, Medical Front Office, or Medical Billing experience.
Direct Reports:
- 10 direct reports.
Knowledge, Competencies & Skills:
- Excellent customer service skills.
- Proven ability and expertise leading a team and process.
- Attention to detail and willingness to learn and apply constructive feedback.
- Proficient knowledge of Medical Terminology; ICD-10, and CPT-4 Codes.
- Strong written and verbal communication skills.
- Proficient computer software and database skills.
- Strong attention to detail.
- Ability to multi-task and work in a fast-paced environment.
- Collection background is a plus.
- Urology background is a plus.
- Ability to type a minimum of 40 words per minute.
Travel:
- Occasionally travel to clinics within the geographic region to observe clinic/ASC workflows for training is optional.
Physical Requirements for the Job:
- Regularly required to sit 4-7 hours daily and stand 1-3 hours daily.
- Intermittently required to stoop, bend, speak, and listen.
- Frequently lift and or move up to 10 pounds and occasionally lift and/or move up to 25 pounds.
Equal Opportunity Employer: United Urology Group and its affiliate practices are an equal opportunity employer. We do not discriminate based on race, color, religion, age, sex, national origin, disability, veteran status, or sexual orientation.
The successful candidate(s) for any UUG position will be subject to a pre-employment background check.
Actual compensation offered to candidates is based on work experience, education, and/or skill level.