Daytime Precertification Specialist — Medical Auths & Care

SLMG Saint Luke's Physician Group, Inc.; Kansas City (MO); On-site; USD 42,000 - 62,000; Full time

Job summary

Saint Luke’s Health System is seeking a Precertification Specialist for our Plaza location. The role supports obtaining prior authorizations for procedures, tests, and surgeries, coordinating with physicians, staff, and payers to determine eligibility and patient responsibility.

The position emphasizes medical background, front desk experience, and insurance knowledge, with a Monday–Friday schedule from 8am to 4:30pm, and no nights or weekends.

Qualifications

• Previous medical background, front desk experience and insurance knowledge preferred.

Responsibilities

• Obtain prior authorizations/pre-certifications for procedures, testing and surgeries as required by payers.
• Collaborate with clinicians, staff and payer representatives to gather and submit information and communicate patient benefits and out-of-pocket costs.
• Obtain precertifications for in-clinic procedures, testing, surgeries and injections; coordinate with physician to ensure eligibility criteria.
• Coordinate with the Financial Clearance Center to communicate patient responsibility for facility billing.
• Run Experian reports to obtain physician billing estimates and coordinate information for physician billing portions.
• Communicate with patients to update on prior authorization and patient responsibility for both facility and physician billing.
• Coordinate with OR/ASC staff to obtain scheduling information and communicate with patients.
• Schedule procedures with vendor representatives as needed.

Job description

Saint Luke’s Health System is seeking a Precertification Specialist for our Plaza location. The role supports obtaining prior authorizations for procedures, tests, and surgeries, coordinating with physicians, staff, and payers to determine eligibility and patient responsibility.

The position emphasizes medical background, front desk experience, and insurance knowledge, with a Monday–Friday schedule from 8am to 4:30pm, and no nights or weekends.