Qureos Mentor

Trinity Health-ND

<div>Position Summary:
The Pre-Certification Specialist verifies patient insurance benefits and secures required authorizations to support the timely and compliant delivery of clinical services at Trinity Health. This role reviews payer guidelines, coordinates closely with clinical departments, and communicates with insurance companies to ensure hospital stays and outpatient services are authorized appropriately. Working as part of a collaborative revenue cycle and care coordination team, the Pre-Certification Specialist helps minimize reimbursement risk by obtaining accurate and complete pre certifications. Through attention to detail, clear communication, and dependable follow-through, this position contributes to efficient operations and supports a positive patient experience by ensuring financial processes are handled promptly and accurately.
Key Responsibilities:<ul><li>
Verify insurance eligibility and coverage for scheduled and unscheduled services using payer websites, electronic systems, and direct communication with insurance representatives.</li><li>
Obtain required authorizations for inpatient admissions, extended stays, outpatient procedures, and diagnostic testing in accordance with each payer&rsquo;s rules.</li><li>
Document authorization details accurately and promptly in the appropriate Trinity Health systems to support billing and clinical workflows.</li><li>
Communicate with clinical departments, schedulers, providers, and the Business Office to clarify requirements and resolve authorization-related issues.</li><li>
Monitor high-volume workloads, prioritize tasks, and follow up on pending authorizations to ensure timely completion.</li><li>
Maintain working knowledge of payer policies, CPT/ICD-10 coding concepts, and medical terminology to support accurate precertification activities.</li></ul>
Licenses and Certifications Required:<ul><li>
None</li></ul>
Educational Requirements:<ul><li>
High School diploma or equivalent preferred.</li></ul>
Experience Requirements:<ul><li>
Experience with third party payer billing regulations, reimbursement requirements, precertification, insurance eligibility verification, and/or utilization management is preferred.</li><li>
Working knowledge of CPT/ICD10 and medical terminology is preferred.</li></ul>
Special Skills or Training Requirements:<ul><li>
Demonstrated advanced communication and interpersonal skills with all levels of internal and external customers.</li><li>
Self directed, attention to detail.</li><li>
Computer experience.</li><li>
Ability to navigate numerous websites for eligibility and prior authorization.</li><li>
Working knowledge of Microsoft Office Suite applications including Outlook, Word and Excel.</li><li>
Excellent written and oral communication skills.</li><li>
Ability to handle high workload volume.</li><li>
Must be flexible and demonstrate ability to be adaptable.</li></ul>
Physical Requirements:
The Pre-Certification Specialist primarily works in an office or remote setting requiring prolonged periods of sitting, computer use, and telephone communication. Occasional walking, standing, and light lifting of files or office supplies may be necessary. Adequate vision, hearing, and manual dexterity are essential for reviewing electronic records, entering data, and managing multiple computer applications.
Environmental Requirements:
This position functions in a structured office or remote work environment with frequent interaction with internal departments, insurance payers, and clinical staff. The role involves managing multiple tasks, navigating numerous software systems, and meeting time-sensitive deadlines. The specialist must follow organizational privacy, confidentiality, and data security standards when handling protected health information.</div>

Pre-Certification Specialist

<div>Position Summary:
The Office Assistant supports daily front-office operations by providing courteous, efficient, and accurate administrative services within the clinic setting. This role greets patients, coordinates registration and scheduling, answers incoming calls, collects payments, and ensures each interaction reflects a high standard of customer service. Working closely with clinical and administrative staff, the Office Assistant helps maintain smooth clinic workflow by keeping records organized, supporting clear communication, and responding effectively to changing operational needs. This position functions within a collaborative, service-oriented team environment and may also provide coverage in other reception areas as needed to support continuity of care and clinic operations.
Key Responsibilities:<ul><li>
Greet and register patients, verify required information, and process payments in accordance with clinic procedures.</li><li>
Schedule, update, and coordinate patient appointments using electronic scheduling systems to support timely and efficient clinic access.</li><li>
Answer and triage incoming calls, route messages appropriately, and provide clear, courteous communication to patients and staff.</li><li>
Maintain organized front office operations by preparing forms, updating records, managing incoming documents, and supporting daily administrative tasks.</li><li>
Protect patient confidentiality by handling sensitive information in compliance with privacy and organizational policies.</li><li>
Provide cross coverage in other reception or clinic areas to support continuity of operations during staff absences or high volume periods.</li></ul>
Licenses and Certifications Required:<ul><li>
None</li></ul>
Educational Requirements:<ul><li>
HS Diploma or GED, preferred</li></ul>
Experience Requirements:<ul><li>
Customer service experience or training, required. Preferably six (6) months minimum</li><li>
Experience in a clerical or office setting, preferred</li><li>
Medical terminology knowledge, preferred</li><li>
Experience with computer appointment software, preferred</li></ul>
Special Skills or Training Requirements:<ul><li>
Ability to communicate effectively in person and on the telephone</li><li>
Ability to demonstrate good judgement in handling incoming calls and in person patients efficiently and appropriately</li><li>
Exceptional interpersonal, customer service, problem solving, verbal and written communication and conflict resolution</li><li>
Ability to handle confidential and sensitive information</li><li>
Ability to work in a fast paced environment; working efficiently and multitasking</li><li>
Compliance with all Privacy and Confidentiality Standards per Trinity&rsquo;s policies</li></ul>
Physical Requirements:
The Office Assistant primarily performs work at a computer workstation, requiring frequent sitting with intermittent standing, walking, reaching, and handling of office materials. The role may involve occasional lifting or carrying of light items such as supplies or paperwork. Adequate vision, hearing, and verbal communication skills are essential for interacting with patients, managing phone calls, and completing detailed clerical tasks.
Environmental Requirements:
Work occurs in an outpatient clinic reception environment with routine contact with patients, families, and clinical staff. The role may involve frequent interruptions, moderate noise, and proximity to patient-care areas. Adherence to safety practices, infection-prevention protocols, and confidentiality standards is required when working with patient information and navigating shared clinic spaces.</div>

Office Assistant, Occupational Medicine

Office Assistant, Patient Registration

Join Trinity Health-ND and explore 3   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Trinity Health-ND

About Company

Pre-Certification Specialist

Office Assistant, Occupational Medicine

Office Assistant, Patient Registration