Job Overview:This position is responsible for training, daily oversight, and work direction of the Precertification Team and requires demonstrated success as a Precertification Specialist. Maintains the master schedule, covers open shifts, updates PTO calendar. Responsible for the following daily activities: monitoring work flow, assigning work, auditing staff, running reports, and problem solving for staff issues. Supports Manager by attending meetings, providing input for staff performance appraisals and assisting with other duties as assigned. Assists Manager in identifying and implementing process improvement initiatives. Provides staff education to improve performance and is able to work in multiple Service lines. Provides back-up for multiple Precertification Service Lines. Ensures adherence to departmental guidelines and assists with performance measures. This position demonstrates a high degree of job knowledge and skill in the processes related to Insurance Verification and Precertification of Infusion, Radiology and Surgery Service Lines and Inpatient Notification of Admission.Job Requirements:High School Degree in General StudiesProven apptitude for creating and providing trainingUnderstands basic concepts of process improvementAble to perform multiple complex processes2-3 years experience HealthcareJob Responsibilities:Obtains precertification in compliance with established guidelines and processes. Has ongoing knowledge of organizational and payer protocols to determine the amount of time needed to obtain precertification for various service lines. Creates and follows scripting and documentation for precertification in order to maximize reimbursement for the organization. Works a daily dashboard to ensure that all accounts are secured and approved.Responsible for overseeing and delivering training to new and existing Team Members. Supports continuous improvement by identifying errors, problems and issues while making suggestions for correction of problems. Communicates quality issues to staff in a positive manner, OR; coordinates changes and identifies opportunities for improvement. Updates and maintains resource manual with material that is crucial to the success of the Team..Reviews denials to identify trends warrenting process improvement and provides coaching for Team Members. Provides meaningful statistical information and provides a tool for feedback.Corrects quality errors in an appropriate time frame to ensure accurate information flows to billing, OR: Works with management team to identify changes needed in processes. Meets deadlines for projects.Audits precertifications for quality measures, i.e. ensure consistent format for data entry, accuracy of insurance information and appropriatte documentation for approval or possible appeal of billed accounts.Conducts Team Huddles Weekly and communicates important process changes and updates.Other Job-Related Information:Working Conditions:Climbing - RarelyConcentrating - ConsistentlyContinous Learning - ConsistentlyHearing: Conversation - ConsistentlyInterpersonal Communication - ConsistentlyKneeling - RarelyLiftingTriHealth is an equal opportunity employer. We are committed to fostering a diverse and inclusive workforce.