Pre-Authorization & Insurance Verification Specialist

MUSC Health; Lexington (SC); On-site; USD 36,000 - 60,000; Full time

Job summary

MUSC Health in Lexington, SC seeks an Eligibility Specialist to verify patient eligibility, obtain insurance benefits, and secure pre-certifications and referrals for inpatient, outpatient, and ancillary services. You will coordinate with payers and clinical partners to ensure payer requirements are met and maintain accurate documentation in patient records.

As part of MUSC Community Physicians (MCP), this hourly role emphasizes timely communication with payers and internal colleagues to support

Qualifications

• Verifies insurance eligibility and benefits.
• Coordinates pre-certification, authorizations, and referrals with payers.
• Documents required information in patient records.
• Communicates with payers and clinical partners to ensure payer requirements are met.

Responsibilities

• Verify eligibility for services prior to care.
• Obtain necessary authorizations and referrals from payers.
• Inform payers and clinical teams about requirements and status.
• Document all relevant information in the patient record.

Skills

Eligibility verification

Insurance benefits

Pre-certification

Authorization

Referral management

Payer communication

Documentation

Education

High School Degree or Equivalent

Job description

MUSC Health in Lexington, SC seeks an Eligibility Specialist to verify patient eligibility, obtain insurance benefits, and secure pre-certifications and referrals for inpatient, outpatient, and ancillary services. You will coordinate with payers and clinical partners to ensure payer requirements are met and maintain accurate documentation in patient records.

As part of MUSC Community Physicians (MCP), this hourly role emphasizes timely communication with payers and internal colleagues to support