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Become A Certification Specialist

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Working As A Certification Specialist

  • Interacting With Computers
  • Getting Information
  • Making Decisions and Solving Problems
  • Updating and Using Relevant Knowledge
  • Communicating with Supervisors, Peers, or Subordinates
  • $48,620

    Average Salary

What Does A Certification Specialist Do At Heartland Payment Systems, Inc.

* Provide technical support to product group and merchants on new products and integrations.
* Attend walkthroughs of solutions and provide technical feedback and guidance to product group.
* Prepare customized POS test scripts for each solution.
* Verify results from test scripts execution.
* Act as a Subject Matter Expert for new certifications.
* Assist external developers in fixing variances
* Provide support details and hand over to the Technical support group.
* Provide training and create documentation as required to all business units for certified solutions.
* Perform pilot monitoring and analysis prior to rollout of certified solutions
* Provide status reporting to manager as required

What Does A Certification Specialist Do At Vanderbilt University Medical Center

* Obtains timely certification from insurance companies for all elective out-patient specialty surgeries for both the surgeon and the Facility using clinical information and based on pre-certification criteria.
* Achieves timely pre-certification for elective surgical cases or admissions 100% of the time.
* Utilizes all clinical records, including StarChart to efficiently obtain pertinent patient clinical information.
* Utilizes ICD
* and CPT coding resources to accurately assign with minimal or zero error preliminary diagnosis and procedure codes, when required by insurance review companies for authorization.
* Contacts insurance review agencies by phone or fax or insurance company's web-sites to request authorization providing accurate and up-to-date clinical information with zero or minimal error.
* Maintains and applies to daily work, a working knowledge of different pre-certification criteria used by insurance companies, utilizes criteria system in MCIS computer system and applies that knowledge during pre-certification process.
* Handles problematic certification cases for the department and/or clinics through collaboration with physician office, UM and department supervisor.
* Elevates to supervisor problem cases appropriately 100% of the Time.
* Consults with supervisor and/or surgeon/designee when serious difficulties arise to review alternatives to surgery, and documents the outcome in the designated computer system with zero error.
* Performs extensive investigative and follow-up work on cases with pre-certification issues until the issue is resolved.
* Collaborates with IM dept staff and UM dept nurses if questions arise regarding pre-certification with zero or minimal error and provides assistance as needed to the UM and IM staff.
* Effectively communicates and collaborates with physician or physician's office staff in the department and/or clinic to ensure timely and accurate certification is obtained.
* Interacts with medical and professional staff, on a case-by-case basis, to obtain additional clinical documentation for assistance in obtaining certification with zero or minimal error.
* Notifies physician or office staff with zero or minimal error when insurance referral or certification is incomplete or has not been obtained.
* Communicates unsupported medical necessity cases based on review of criteria of insurance denials with physicians or designees.
* Facilitates next step of medical review or obtains pre-certification utilizing additional information from physician or designee. (i.e. facilitating peer to per reviews).
* Serves as a resource to the physicians and office staff and interacts with patient and/or family regarding pre-certification procedures with zero or minimal error.
* Collaborates with insurance companies and physicians to justify if Vanderbilt is sole provider for this procedure, in-network benefits when only out-of-network benefits are available.
* Documents certification process and certification number information for both the physician and the facility correctly and timely in the appropriate computer applications such as EPIC, Medipac, etc. to facilitate accurate concurrent review, billing and reimbursement for the department, clinic, and/or Hospital Facilities.
* Enters authorization number and days approved data into all computers systems to facilitate hospital billing and physician billing with zero or minimal error.
* Enters clear, concise, real-time documentation in the department specific computer system, Medipac, and EPIC of all steps taken with insurance review agency and/or physician when authorization obtained or alternative settings/arrangements are required with zero or minimal error.
* Maintains and updates computer applications daily in comparison to VORS reports in order to capture all surgeries for billing.
* Coordination of payment for the physician and facility for self-pay patients (in-patient as well as out-patient surgeries).
* Coordination of co-pays or monies to be collected from the patient for both the hospital and the physician. (this includes contacting the patient by phone or mail regarding the co-pays/deductibles).
* Obtains referrals for initial Physical Therapy and Occupational Therapy appointments as necessary.
* Also verifies benefits for initial PT and OT appointments based on physician protocols.
* Utilizes appropriate resources to obtain certification for the department or clinic out-patient surgeries.
* Maintains knowledge of and uses the MCIS for insurance contract information, insurance plan descriptions and requirements, and in-service announcements.
* Maintains knowledge and utilizes Insurance Company web-sites to obtain pre-certifications for out-patient elective surgeries.
* TECHNICAL CAPABILITIES:
* CORE ACCOUNTABILITIES:
* CORE CAPABILITIES:
* Associate's Degree (or equivalent experience) and 1 year experience
* Licensure, Certification, and/or Registration (LCR

What Does A Certification Specialist Do At Firelands Regional Medical Center

* Concentration is on prior authorization, precertification and verification of insurance benefits for various services and payers including, but not limited to Managed Care, Commercial/WC payers, Medicare, and insurances secondary to Medicare.
* Information verified must include at a minimum: eligibility, subscriber name, subscriber number, group number, billing address, if prior authorization for specified services is required, co-pay, deductible, co-insurance, policy exclusions, skilled nursing benefits,
* DME, Home Health and psychiatric benefits and services.
* This information is communicated to the appropriate departments.
* Contacts commercial payers as necessary to obtain initial pre-certification and coordinates information to central scheduling, financial counselors or care management for utilization review.
* In the event of an admission, communicate the number of initial days
* authorized for admission.
* Documents on the patient’s Meditech account information obtained regarding insurance benefits, the name of the Insurance Company representative providing the information, their telephone number, the date the information was obtained, a reference number for
* the call, and an authorization number when necessary.
* Obtains outpatient authorizations, sleep lab, and dialysis.
* Informs care management and patient access regarding payer information changes so ADT and Patient accounting systems can be updated to ensure accurate billing.
* Monitors and tracks scheduled surgeries and FRMC Clinics on a daily basis for add-ons.
* Verifies eligibility, ensuring authorization is in place prior to procedure.
* Notifies/Contacts MD office, and/or care management in the event additional information is needed
* to properly authorize the patient stay.
* OTHER TASKS, DUTIES AND RESPONSIBILITIES
* Act as a liaison between central scheduling, registration, care management and the physician’s offices.
* Tracks problem admissions or procedures and works with financial counselors for resolution.
* Participates in department performance improvement activities as assigned and attends required training.
* Demonstrates service excellence and ACE.
* KNOWLEDGE

What Does A Certification Specialist Do At HCA, Hospital Corporation of America

* Review each Medical record to understand the condition and treatments received.
* Extract necessary information to justify the necessity of stay for Insurance approval.
* Analyzing and reviewing medical records for sensitive information that may require special authorizations.
* Communicate directly with Insurance Agency to justify requests for authorization
* Complete necessary forms to submit to agency for approval.
* All other job duties as assigned by management

What Does A Certification Specialist Do At Everett Housing Authority

The following duties are illustrative only (i.e. not all inclusive

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How To Become A Certification Specialist

Because of the wide range of skills used in different computer support jobs, there are many paths into the occupation. A bachelor’s degree is required for some computer support specialist positions, but an associate’s degree or postsecondary classes may be enough for others.

Education

Education requirements for computer support specialists vary. Computer user support specialist jobs require some computer knowledge, but not necessarily a postsecondary degree. Applicants who have taken some computer-related classes are often qualified. For computer network support specialists, many employers accept applicants with an associate’s degree, although some prefer applicants to have a bachelor’s degree.

Large software companies that provide support to business users who buy their products or services often require a bachelor’s degree. Positions that are more technical are likely to require a degree in a field such as computer science, engineering, or information science, but for others, the applicant’s field of study is less important.

To keep up with changes in technology, many computer support specialists continue their education throughout their careers.

Certification

Certification programs are generally offered by vendors or from vendor-neutral certification providers. Certification validates the knowledge of and best practices required by computer support specialists. Companies may require their computer support specialists to hold certifications in the products the companies use.

Advancement

Many computer support specialists advance to other information technology positions, such as network and computer systems administrators and software developers. Some become managers in the computer support services department. Some organizations provide paths for support specialists to move into other parts of the organization, such as sales. For more information, see the profiles on network and computer systems administrators and software developers.

Important Qualities

Customer-service skills. Computer support specialists must be patient and sympathetic. They must often help people who are frustrated with the software or hardware they are trying to use.

Listening skills. Support workers must be able to understand the problems that their customers are describing and know when to ask questions to clarify the situation.

Problem-solving skills. Support workers must identify both simple and complex computer problems, analyze them, and solve them.

Speaking skills. Support workers must describe the solutions to computer problems in a way that a nontechnical person can understand.

Writing skills. Strong writing skills are useful for preparing instructions and email responses for employees and customers, as well as real-time web chat interactions.

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Certification Specialist jobs

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Certification Specialist Demographics

Gender

  • Female

    74.8%
  • Male

    24.2%
  • Unknown

    1.1%

Ethnicity

  • White

    80.6%
  • Hispanic or Latino

    10.1%
  • Asian

    7.2%
  • Unknown

    1.5%
  • Black or African American

    0.6%
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Languages Spoken

  • Spanish

    60.0%
  • French

    10.0%
  • Italian

    6.7%
  • Swahili

    3.3%
  • Vietnamese

    3.3%
  • German

    3.3%
  • Urdu

    3.3%
  • Carrier

    3.3%
  • Bengali

    3.3%
  • Russian

    3.3%
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Certification Specialist

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Certification Specialist Education

Certification Specialist

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Real Certification Specialist Salaries

Job Title Company Location Start Date Salary
3Gpp Certification Specialist Research In Motion Corporation Sunrise, FL Oct 01, 2011 $75,240
Foreign and Domestic Certification Specialist Securaplane Technologies, Inc. Tucson, AZ Jan 01, 2011 $74,234
Foreign and Domestic Certification Specialist Securaplane Technologies, Inc. Tucson, AZ Jan 01, 2012 $74,234
Testing & Language Certification Specialist/Teacher La Scuola D'Italia Guglielmo Marconi New York, NY Jan 08, 2016 $56,000
Testing & Language Certification Specialist/Teacher La Scuola D'Italia Guglielmo Marconi New York, NY Sep 09, 2016 $56,000
Claims Reporting & Certificate Specialist The Kettrles Company, Inc. Islandia, NY Nov 20, 2013 $52,000

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Top Skills for A Certification Specialist

InsuranceCompaniesDataEntryCustomerServiceFinancialSafetyMedicaidMedicalProceduresAssuranceHUDInsuranceCoverageCommunicatesInsuranceInformationCPTCertificationProcessEmergencyMedicalNecessityElectronicMedicalRecordClinicalInformationClinicalLaboratoryInsuranceVerificationPhoneCalls

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Top Certification Specialist Skills

  1. Insurance Companies
  2. Data Entry
  3. Customer Service
You can check out examples of real life uses of top skills on resumes here:
  • Obtain authorizations for surgeries, physical therapy, and radiology tests from various s medical insurance companies.
  • Perform detailed and accurate patient data entry to include notes, insurance information and medical history.
  • Provided customer service for the overall Registrar in person, via email and over the phone.
  • Compiled, recorded, and evaluated personal and financial data in order to verify completeness and accuracy.
  • Screened and interviewed families, completed background checks, and home safety inspections.

Top Certification Specialist Employers

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