OB-GYN Pre-Certification & Benefits Coordinator

Socket.dev

Baton Rouge (LA)

On-site

USD 33,000 - 42,000

Full time

5 days ago

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Benefits offered by this job

Health insurance

401(k)

Paid time off

Job summary

Louisiana Women’s Healthcare in Baton Rouge seeks a full-time Pre-Certification Specialist to support a high-volume obstetrics clinic. This role obtains insurance benefits, verifies eligibility, and secures pre-authorizations for procedures, acting as liaison between providers, patients, and insurers.

The specialist ensures timely approvals, maintains documentation, and complies with HIPAA and payer policies.

Qualifications

High school diploma or equivalent.
Experience in a medical office or healthcare setting.
Working knowledge of insurance authorization requirements and workflows.
Understanding of HIPAA and strict adherence to patient confidentiality standards.
Must demonstrate punctuality and reliable attendance.

Responsibilities

Verifying insurance coverage and eligibility – Confirm patients’ insurance benefits and authorizations.
Communication – Clarify coverage, authorization issues, and estimated amounts due with staff and patients.
Obtain prior authorizations – Complete the authorization process with payers to ensure coverage.
Maintain documentation – Keep accurate records of benefits and authorization status.
Gather and submit documentation – Collect all required clinical and administrative information.
Maintain compliance – Adhere to HIPAA and payer protocols to protect privacy.
Follow up and resolve issues – Track authorization status and address denials.
Benefits – ensure obstetrical patients and procedures have benefits completed and documented.
System maintenance – Update insurance policy info and patient demographics as needed.