Healthcare Precertification Specialist Precise Authorizations

7400 MMG Specialists LLC; United States; On-site; USD 42,000 - 62,000; Full time

Job summary

Methodist Le Bonheur Healthcare in Memphis seeks a precertification specialist to ensure medical services meet insurer guidelines for inpatient, diagnostic, and outpatient care. You will coordinate documentation and work closely with physicians, office staff, patients, and the healthcare team.

Required is a high school diploma or equivalent, with 1–3 years of medical insurance authorizations or clinical experience; LPN is preferred.

Qualifications

• High School Diploma or equivalent is required.
• Medical insurance authorizations and/or clinical experience (1-3 years).
• Knowledge of CPT, HCPCS, and ICD-10 codes preferred.
• Strong attention to detail and critical thinking.
• Excellent verbal and written communication skills.

Responsibilities

• Responsible for precertification of eligible medical services and procedures for inpatient, diagnostic, and outpatient services.
• 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.

Skills

Medical insurance authorizations

Clinical experience

CPT/HCPCS/ICD-10 knowledge

Attention to detail

Verbal and written communication

Education

High School Diploma or Equivalent

Tools

Healthcare information system

Microsoft Word

Job description

Methodist Le Bonheur Healthcare in Memphis seeks a precertification specialist to ensure medical services meet insurer guidelines for inpatient, diagnostic, and outpatient care. You will coordinate documentation and work closely with physicians, office staff, patients, and the healthcare team.

Required is a high school diploma or equivalent, with 1–3 years of medical insurance authorizations or clinical experience; LPN is preferred.