Payer Precertification & Authorization Specialist

Mercyhealth; Harvard, Northern (IL, KY); Hybrid; USD 24,000 - 39,000; Full time

Job summary

Mercy Assisted Care Home Medical Equipment & Supplies in Harvard, IL seeks a Precertification Specialist to coordinate insurance precertifications and determinations, verify eligibility, benefits, and required documentation across systems.

Responsibilities include contacting insurers, gathering clinical data, ensuring timely authorizations, and maintaining payor compliance while protecting patient confidentiality.

Qualifications

• High school diploma or equivalent preferred.
• One year of precertifications, medical billing, registration, or healthcare experience preferred.
• Excellent oral communication and organizational skills required.
• Ability to handle stress and problem solve.
• Computer experience required; Epic knowledge preferred.

Responsibilities

• Identify patients needing pre-certification through multiple systems.
• Obtain necessary clinical data and documentation for precertification.
• Contact insurers to obtain pre-certifications and determine eligibility.
• Follow up on insurance issues to secure financial resolution.
• Maintain payor requirements and ensure documentation for payment.

Skills

Excellent communication

Organizational skills

Problem solving

Computer experience

Independent work

Education

High school diploma or equivalent

Tools

Epic

Job description

Mercy Assisted Care Home Medical Equipment & Supplies in Harvard, IL seeks a Precertification Specialist to coordinate insurance precertifications and determinations, verify eligibility, benefits, and required documentation across systems.

Responsibilities include contacting insurers, gathering clinical data, ensuring timely authorizations, and maintaining payor compliance while protecting patient confidentiality.