Member Certification Specialist jobs in Indiana
Member Certification Specialist coordinates the certification and credentialing programs of a professional or membership organization. Participates in the development of standards and the creation of testing materials. Being a Member Certification Specialist maintains and monitors a test scheduling system or database. Organizes resources to implement testing schedules and sessions, including locations, testers, technology, and materials. Additionally, Member Certification Specialist assists members with information about programs and resolves any issues with the process. Interfaces with and monitors outside testing providers. May require a bachelor's degree. Typically reports to a manager. The Member Certification Specialist occasionally directed in several aspects of the work. Gaining exposure to some of the complex tasks within the job function. To be a Member Certification Specialist typically requires 2-4 years of related experience. (Copyright 2024 Salary.com)
Recently Added Member Certification Specialist jobs
Pre-Certification and Scheduling Specialist
- Lakeshore Bone & Joint Institute
-
Chesterton, IN
FULL_TIME
-
Job Description
As the region's dedicated experts in exceptional musculoskeletal care, our doctors and staff at Lakeshore Bone & Joint Institute have served the orthopedic needs of Northwest Indiana since 1968. With state-of-the-art facilities, we are dedicated to delivering the exceptional, compassionate care that our patients need to keep moving and keep enjoying their life.
The Pre-Certification and Scheduling Specialist is responsible for the following tasks:
Precertification/Prior Authorization & Scheduling- MRI
- PT/DME
- Surgery
- In Office Injections
Essential Functions- Obtain authorization via payer website or by phone and follow up regularly on pending cases.
- Prioritize incoming authorization requests according to urgency.
- Maintain individual payer files to include up to date requirements needed to successfully obtain authorizations.
- Initiate appeals for denied authorizations.
- Schedule and coordinate patient surgeries and MRI’s.
- Communicate with surgical facilities and send all necessary surgical forms.
- Review surgery schedule with facilities the day before surgery; create and send email to physicians.
- Meet deadlines as determined by the date of procedure.
- Respond to clinic questions regarding payer medical policy guidelines.
- Confirm accuracy of CPT and ICD-10 diagnoses in the procedure order.
- Contact patients to discuss authorization status.
- Document all work in practice management system.
- Other duties as assigned.
- Strong attention to details.
- Time Management, prioritization, and sense of urgency.
- Basic understanding of insurance rules and regulations.
- CPT/ICD10 knowledge.
- Medical terminology.
- HIPAA compliance.
Work is performed in an office environment. Involves frequent contact with patients, physicians, and other healthcare personnel. Work may be stressful at times. Interaction with others is constant and interruptive. It is possible work may involve interaction with injured and/or sick patients.
Role Qualifications- Must be at least 18 years of age.
- Must have reliable transportation.
- Proficiency in Microsoft Word, Excel and Outlook preferred.
- Digital literacy.
- Work experience in a medical office setting preferred but will train the right candidate.
- Healthcare related background including surgical terminology preferred.
- Scheduling and pre-authorization experience preferred.
High school diploma or the equivalent.
Required Skills- Critical thinking and problem solving.
- Maintains composure and operates with emotional intelligence.
- Strong attention to detail.
- Receptive to and responsive to feedback.
- Excellent verbal and written communication skills.
- Time management, prioritization, and sense of urgency.
While performing the duties of this job, the employee may be required to sit and/or stand for prolonged periods, work longer than eight (8) hour shifts, and to work both day/evening shifts. Work may require hand dexterity as well as the need to reach, climb, balance, stoop, kneel, crouch, talk, and hear. While performing the responsibilities of the job, the employee is required to talk and hear. Specific vision abilities required by the job include close vision and the ability to focus. Reasonable accommodation can be made to enable people with disabilities to perform the described essential functions of the job.
Compliance
All employees have a responsibility to comply with our organization’s policies and procedures, adhere to our Code of Conduct, complete required compliance training modules, and report any observations of non-compliance.
EEO Statement
We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status. - 1 Day Ago
Legal Clerk (Certification Specialist)
- Steneral Consulting
-
Indianapolis, IN
FULL_TIME
- Essential Duties/Responsibilities Audits all certification applications, both new and re-certifications, to determine program eligibility, reviews requests for certification based on agreements with o...
- 16 Days Ago
MWBE Certification Specialist
- Dizer Corp
-
Indianapolis, IN
FULL_TIME
- We are seeking a MWBE Certification Specialist for one of our clients, Indianapolis INPlease share the updated resume @ sandeep@dizercorp.comJob Title: MWBE Certification SpecialistLocation: Indianapo...
- 16 Days Ago
MWBE Certification Specialist
- Anveta, Inc
-
Indianapolis, IN
CONTRACTOR
- Role: MWBE Certification Specialist Location : Indianapolis, IN Duration: 6 MonthsJob DescriptionEssential Duties/Responsibilities: Audits all certification applications, both new and re-certification...
- 17 Days Ago
Pre-Certification and Scheduling Specialist
- Lakeshore Bone & Joint Institute Career Center
-
Chesterton, IN
FULL_TIME
- Job Description As the region's dedicated experts in exceptional musculoskeletal care, our doctors and staff at Lakeshore Bone & Joint Institute have served the orthopedic needs of Northwest Indiana s...
- 21 Days Ago
MWBE Certification Specialist
- ITCommence Inc
-
Indianapolis, IN
FULL_TIME
- Role: MWBE Certification SpecialistLocation: Indianapolis IN 46204 - onsiteDuration: 1 year contractInterview: Phone and in-personRequired Skills: Preferably have a legal background; J.D. or Paralegal...
- 29 Days Ago
Member Certification Specialist jobs at Popular Companies
Regulatory Certification Specialist 23-00850
- ESPO Corporation
-
Arlington Heights, IL
- Title: Regulatory Certification Specialist Location: Arlington Heights, IL Duration: Permanent Hire Reports to: Engineer...
- 6/10/2024 12:00:00 AM
Pre-Certification Specialist,
- Valley Health System
-
Ridgewood, NJ
- Responsible for obtaining and providing accurate and complete data input for precertification/preauthorization from insu...
- 6/10/2024 12:00:00 AM
Senior Housing Assistant Rental Specialist - Certification Specialist
- Division 10 Personnel
-
Milwaukee, WI
- Job Description Job Description Code: 2121 Location: Milwaukee, WI Job Description: Senior Housing Assistant Rental Spec...
- 6/10/2024 12:00:00 AM
Licensing and Certification Specialist
- Synergy Healthcare Solutions
-
Atlanta, GA
- Administration | 55000-65000 per year | 1040 Crown Pointe Pkwy, Dunwoody, GA, USA | Salary | Synergy Healthcare Services...
- 6/8/2024 12:00:00 AM
Site Certification Specialist - Monarch Mills
- Humphrey Management
-
Columbia, MD
- Monarch Mills is looking for a site based Certification Specialist. The ideal candidate should be organized, have attent...
- 6/8/2024 12:00:00 AM
Certification Specialist
- Highmark Residential, LLC
-
Raleigh, NC
- Overview: Location: Central on the Green Why Highmark Residential? Because every position is considered critical to High...
- 6/7/2024 12:00:00 AM
Inside Sales - Government Contract and Certification Specialist
- Government Services Exchange
-
Clearwater, FL
- Job Description Job Description Inside Sales – Government Contract and Certification Specialist Government Services Exch...
- 6/7/2024 12:00:00 AM
Long Term Temporary Position Certification Specialist
- Travaux Inc.
-
Milwaukee, WI
- Job Description Job Description CLASS SUMMARY: This position is responsible for performing technical and support tasks r...
- 6/7/2024 12:00:00 AM
About Indiana
Indiana /ˌɪndiˈænə/ (listen) is a U.S. state located in the Midwestern and Great Lakes regions of North America. Indiana is the 38th largest by area and the 17th most populous of the 50 United States. Its capital and largest city is Indianapolis. Indiana was admitted to the United States as the 19th U.S. state on December 11, 1816. Indiana borders Lake Michigan to the northwest, Michigan to the north, Ohio to the east, Kentucky to the south and southeast, and Illinois to the west.
Before becoming a territory, various indigenous peoples and Native Americans inhabited Indiana for thousands of ye...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Member Certification Specialist jobs
$68,841 to $106,589
Most Popular Cities in Indiana for Member Certification Specialist Jobs
What does a Member Certification Specialist do?
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