Payer-Focused Precertification & Authorization Pro

Medical University of South Carolina; Charleston (SC); On-site; USD 25,000 - 39,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Life insurance

Retirement plan

Paid time off

Parental leave

Disability insurance

Training and development

Competitive pay and merit increase

Wellbeing resources

Tuition reimbursement

Employee discounts

Referral program

Flexible schedule

Certification incentive program

Job summary

The Medical University of South Carolina is seeking a Precertification Specialist to verify eligibility, obtain insurance benefits, and ensure pre-certification, authorization, and referral requirements are met prior to the delivery of inpatient, outpatient, and ancillary services.

This role coordinates with payers and clinical partners to obtain necessary authorizations and documents details in patient records.

Qualifications

• Education: High School Degree or Equivalent.
• Work Experience: 1 year.

Responsibilities

• Verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to delivering inpatient, outpatient, and ancillary services.
• Determine which patient services have third party payer requirements and obtain necessary authorizations via phone, fax, or payer websites.
• Provide detailed and timely communication to payers and clinical partners to facilitate compliance with payer requirements and document information in patient records.
• Other duties as assigned.

Education

High School Degree or Equivalent

Job description

The Medical University of South Carolina is seeking a Precertification Specialist to verify eligibility, obtain insurance benefits, and ensure pre-certification, authorization, and referral requirements are met prior to the delivery of inpatient, outpatient, and ancillary services.

This role coordinates with payers and clinical partners to obtain necessary authorizations and documents details in patient records.