Medical Authorization Specialist: Precert & Insurance

Methodist Le Bonheur Healthcare; Memphis (TN); Hybrid; USD 38,000 - 58,000; Full time

Job summary

Methodist Le Bonheur Healthcare in Memphis seeks a precertification specialist to manage authorizations for inpatient, diagnostic, and outpatient services based on plans and medical necessity.

The role requires knowledge of CPT/HCPCS/ICD-10 codes, strong attention to detail and communication skills, and experience with insurance authorizations and a healthcare information system. A Tennessee LPN license is preferred.

Qualifications

• High School Diploma or Equivalent required.
• Medical insurance authorizations and/or clinical experience 1–3 years required.
• Licensed Practical Nurse (TN) preferred.

Responsibilities

• Precertification of eligible medical services and procedures for inpatient, diagnostic, and outpatient services.
• Coordinate documentation required for precertification.
• Establish good working relationships with physicians, office staff, patients, and healthcare team.

Skills

Attention to detail

Analytical ability

Verbal & written communication

Microsoft Word

Healthcare information systems

PPO/Managed care experience

Education

High School Diploma or Equivalent

Tools

Microsoft Word

Healthcare information system

Job description

Methodist Le Bonheur Healthcare in Memphis seeks a precertification specialist to manage authorizations for inpatient, diagnostic, and outpatient services based on plans and medical necessity.

The role requires knowledge of CPT/HCPCS/ICD-10 codes, strong attention to detail and communication skills, and experience with insurance authorizations and a healthcare information system. A Tennessee LPN license is preferred.