Authorization Specialist | FT | Weekdays | Neurology Clinic | Memphis

Methodist Le Bonheur Healthcare; Memphis (TN); On-site; USD 42,000 - 54,000; Full time

Job summary

Methodist Le Bonheur Healthcare in Memphis is seeking a precertification clerk to manage authorizations for inpatient, diagnostic, and outpatient services. You will ensure complete documentation for insurer guidelines and collaborate with physicians and care teams to secure approvals.

The role emphasizes attention to medical necessity, accurate coding references (CPT/HCPCS/ICD-10), and strong written and verbal communication in a fast-paced healthcare environment.

Qualifications

• Requires High School diploma or equivalent.
• 1–3 years of medical insurance authorizations experience.
• Knowledge of CPT/HCPCS/ICD-10 codes preferred.

Responsibilities

• Precertify eligible medical services and procedures for inpatient, diagnostic, and outpatient settings.
• Coordinate and prepare all documentation required for precertification.
• Maintain accurate records and communicate with physicians, office staff, patients, and payers.

Skills

Analytical skills

Attention to detail

Verbal & written communication

Microsoft Word

Education

High School Diploma or Equivalent

Tools

Healthcare information system

CPT/HCPCS/ICD-10 knowledge

Job description

If you are looking to make an impact on a meaningful scale, come join us as we *embrace the Power of One!*We strive to be an employer of choice and establish a reputation for being a talent rich organization where Associates can grow their career caring for others. For over a century, we’ve served the health care needs of the people of Memphis and the Mid-South.Responsible for precertification of eligible medical services and procedures for inpatient, diagnostic, and outpatient services. Ensures complete documentation is obtained that meets insurer guidelines for medical necessity and payment for services. Models appropriate behavior as exemplified in MLH Mission, Vision and Values.Working at MLH means carrying the mission forward of caring for our community and impacting the lives of patients in every way through compassion, a deliberate focus on service expectations and a consistent thriving for excellence.*A Brief Overview*Responsible for precertification of eligible medical services and procedures for inpatient, diagnostic, and outpatient services. Ensures complete documentation is obtained that meets insurer guidelines for medical necessity and payment for services. Models appropriate behavior as exemplified in MLH Mission, Vision and Values.*What you will do** Responsible for precertification of eligible medical services and procedures for inpatient, diagnostic, and outpatient services based on medical plan documents and medical necessity. Manages pre-certifications for more complex surgical and invasive procedures that require strong clinical knowledge.* Coordinates all documentation required for precertification of services.* Establishes a good working relationship with physicians, physician office staff, patients, and other members of the healthcare team.*Education/Formal Training Requirements** Required - High School Diploma or Equivalent*Work Experience Requirements** Required - Medical insurance authorizations and/or clinical experience 1-3 years*Licenses and Certifications Requirements** Preferred - Licensed Practical Nurse - Tennessee - Tennessee Board of Nursing*Knowledge, Skills and Abilities** Knowledge and experience in coverage practices, terminology, and requirements for referrals and authorization/pre-certification used by third party payers, Medicare, and secondary payer rules.* Knowledge of CPT, HCPCS, and ICD-10 codes preferred.* Demonstrated analytical ability to collect and interpret insurance and contract information.* Experience dealing with PPO and Managed Care insurance.* Strong attention to detail and critical thinking skills.* Experience with a computerized healthcare information system required. Familiarity with fundamental Microsoft Word software.* Excellent verbal and written communication skills.*Supervision Provided by this Position** There are no lead or supervisory responsibilities assigned to this position.*Physical Demands** The physical activities of this position may include climbing, pushing, standing, hearing, walking, reaching, grasping, kneeling, stooping, and repetitive motion.* Must have good balance and coordination.* The physical requirements of this position are: light work - exerting up to 25 lbs. of force occasionally and/or up to 10 lbs. of force frequently.* The Associate is required to have close visual acuity to perform an activity, such as preparing and analyzing data and figures; transcribing; viewing a computer terminal; or extensive reading.* The conditions to which the Associate will be subject in this position: The Associate is not substantially exposed to adverse environmental conditions; job functions are typically performed under conditions such as those found in general office or administrative.Our Associates are passionate about what they do, the service they provide and the patients they serve. We value family, team and a Power of One culture that requires commitment to the highest standards of care and unity.Boasting one of the South's largest medical centers, Memphis blends a friendly community, a thriving and growing downtown, and a low cost of living. We see each day as a new opportunity to make a difference in the lives of the people in our community.