Clinical Pre-Authorization & Revenue Cycle Specialist

Mary Rutan Health; Bellefontaine (OH); On-site; USD 40,000 - 56,000; Full time

Job summary

Mary Rutan Health in Bellefontaine, OH, seeks a Pre-Service Clerk to coordinate precertification/authorization for scheduled services. You will contact insurance companies, physicians, and patients, ensuring timely determinations and adherence to payer guidelines.

The role requires strong communication, knowledge of medical terminology, and experience in healthcare revenue cycle. You will collaborate with clinicians and payors to support accurate and efficient approvals.

Qualifications

• Minimum education: high school diploma or GED.
• At least two years of Revenue Cycle experience with precertification/authorization.
• Understanding of medical terminology and clinical documentation.

Responsibilities

• Contact insurance companies, physicians, and patients to determine precertification/authorization for scheduled services.
• Liaise with physician offices and third-party payors to coordinate approvals.
• Ensure adherence to payor medical necessity guidelines and MRH policies.
• Perform payor notifications for non-scheduled inpatient encounters.

Skills

Interpersonal skills

Verbal and written communication

Education

High school diploma or GED

Tools

Microsoft Outlook

Microsoft Excel

Job description

Mary Rutan Health in Bellefontaine, OH, seeks a Pre-Service Clerk to coordinate precertification/authorization for scheduled services. You will contact insurance companies, physicians, and patients, ensuring timely determinations and adherence to payer guidelines.

The role requires strong communication, knowledge of medical terminology, and experience in healthcare revenue cycle. You will collaborate with clinicians and payors to support accurate and efficient approvals.