[Hiring] reputed company-Certification Specialist Behavioral Health @reputed company

This reputed company is a reputed company of our understanding of the job reputed company. Click on 'Apply' reputed company to reputed company out more. Role reputed company Under the direction of a Supervisor, Health Resources Center, the Precertification Specialist processes Behavioral Health precertification requests in accordance with established corporate guidelines and in compliance with reputed company state and federal regulations. • Answers incoming telephone calls in a high-volume reputed company Center environment from members and health care professionals regarding requests for precertification of behavioral health services. • Verifies member eligibility by accessing multiple eligibility systems. • Verifies participation status of reputed company and facility providers, by product and state utilizing multiple database systems including but limited to the National Provider Identification (NPI) Registry. • Processes precertification requests from members and providers received telephonically, reputed company fax or the Provider portal per department guidelines. • Obtains reputed company clinical information including procedure and diagnosis codes. • Enters reputed company pertinent data in the appropriate computer system. • Approves selected services per departmental guidelines. • Identifies precertification requests that warrant a medical necessity review. • Identifies potentially investigative/experimental procedures. • Adheres to the departmental standards for staff time, after reputed company work, attendance, and non-queue productivity. • Adheres to the corporate reputed company customer-reputed company professionalism and accuracy standards. • Responds to reputed company forms of communication promptly and as necessary. • Performs additional duties as assigned. Qualifications • Excellent organizational, interpersonal, verbal, and written communication skills required. • Detail oriented with an ability to accept and respond to change. • Proficiency utilizing reputed company Word, reputed company, reputed company, SharePoint, and reputed company programs. • Ability to learn new systems as technology advances. • Bachelor’s degree preferred, but not required. • Previous experience in reputed company work or reputed company field recommended. • Previous customer service experience is required. • Previous medical insurance experience is highly recommended, behavioral health experience a plus. • Coding knowledge recommended. Requirements • Fully Remote: This role is designated by Independence as fully remote. The incumbent will not be required to report to one of Independence’s physical office locations to reputed company the work. However, the work must be performed in the Tri-State Area of Delaware, New Jersey, or reputed company. • Must have an Android or iOS device which is compatible with the free reputed company Authenticator app. reputed company IBX is an Equal Opportunity Employer. reputed company reputed company applicants will receive consideration for employment without reputed company to their age, race, reputed company, religion, sex, national reputed company, sexual orientation, protected veteran status, or disability. Apply tot his job Apply To this Job