Pre-Certification Specialist I (Finance)
As one of the nation's leading pediatric health care systems, Nemours is committed to providing all children with their best chance to grow up healthy. We offer integrated, family-centered care to more than 300,000 children each year in our pediatric hospitals, specialty clinics and primary care practices in Delaware, Florida, Maryland, New Jersey and Pennsylvania. Nemours strives to ensure a healthier tomorrow for all children – even those who may never enter our doors – through our world-changing research, education and advocacy efforts. At Nemours, our Associates help us deliver on the promise we make to every family we have the privilege of serving: to treat their child as if they were our own.
Equity, diversity, and inclusion guide our growth and strategy. We are looking for individuals who are passionate about, and committed to leading efforts to provide culturally relevant care, reducing health disparities, and helping build a diverse and inclusive team environment. All Nemours associates are expected to ensure that these philosophies are embedded in their day to day work with colleagues, patients and families.Nemours is seeking a Pre-Certification Specialist I (FULL-TIME), to join our Nemours Children's Specialty Care team in Jacksonville, Florida.
At our three clinic locations in the Jacksonville area, Nemours is a leading provider of pediatric specialty care in north Florida with many of our pediatric specialists regularly recognized as the “Best Doctors in America®.” We offer comprehensive, family-centered care in more than 30 pediatric specialties. Several of those specialties, offered in collaboration with Wolfson Children's Hospital, have been named among the best in the country by U.S. News & World Report.
Work Schedule: 8:00am - 5:00pm
Detail oriented with above average organizational skills
Ability to multitask and remain focused while managing a high-volume, time-sensitive workload.
Proficient use of CPT and ICD-10 codes.
Knowledge of procedure authorization and its direct impact on the practice's revenue cycle.
Understanding of payer medical policy guidelines while utilizing these guidelines to manage authorizations effectively.
Basic understanding of human anatomy.
Excellent computer skills including Excel, Word, and Internet use.
Plans and prioritizes to meet deadlines.
Excellent customer service skills; communicates clearly and effectively.
***EXTERNAL APPLICANTS: Please be advised if you apply to this position, you will be asked to take an assessment as part of the application process. This could add an additional 20 to 45 minutes, based upon the assessment that corresponds with this position. Please allow yourself enough time to complete the test, as you will not be able to save your application and come back to complete it at a later time. Do not use your mobile phone to apply to this position; our assessment is not compatible with mobile devices at this time ***
Our dedication to professionals who are dedicated to children frequently earns Nemours a spot on the list of top workplaces in the communities we serve. Our Associates enjoy comprehensive benefits, including our unique “Bridge to a Healthy Future” pediatric health plan, an integrated wellness program, opportunities for professional growth, and much more. As an equal opportunity employer, Nemours focuses on the best-qualified applicants for our openings.