Pre Cert Rep

Marshall Medical Centers; Madison (AL); Presencial; USD 36.000 - 48.000; Jornada completa

Descripción de la vacante

The Pre-Certification Representative at Huntsville Hospital Health System handles obtaining approvals from insurance for services requiring referral, pre-certification or prior authorization, ensuring compliance with HIPAA and healthcare regulations. The role emphasizes accuracy and efficiency in processing a high volume of requests.

The ideal candidate has a high school diploma or GED, 3 years of medical insurance/billing experience, and familiarity with EMR/billing systems, medical

Formación

• High School diploma or GED required; post-secondary education preferred.
• 3 years of medical insurance or medical billing experience required.
• Experience with pre-certifications preferred.

Responsabilidades

• Obtain insurer approvals for services requiring referral, pre-certification, or prior authorization.
• Maintain HIPAA-compliant handling of protected health information.
• Collaborate with care teams to resolve authorization issues and ensure timely patient care.

Conocimientos

Verbal & written communication

Attention to detail

High-volume work management

Educación

High School diploma or GED

Post-secondary education (preferred)

Herramientas

EMR / Billing systems

Word

Excel

Descripción del empleo

Overview

The Pre-Certification Representative is responsible for obtaining approval from insurance companies for services that require referral, pre-certification or prior authorization. All job functions are performed in a manner that promotes the highest level of compliance with various legal, regulatory and accreditation requirements while maintaining all protected health information in manner that complies with HIPAA requirements.

Qualifications

Education: High School diploma or GED required; post-secondary education preferred.

Experience: Three years of medical insurance or medical billing experience required; One year of prior experience with pre-certifications preferred

Additional Skills/Abilities: Proficiency working with computer applications, including Word, Excel and EMR/Billing systems required. Understanding of medical terminology and general medical billing processes, including accounts receivable required. Basic understanding of medical coding required. Broad understanding of insurance company requirements related to services that require referral, pre-certification or prior authorization required. Ability to process a high volume of work in an accurate manner required. Ability to communicate effectively both verbally and in writing required. Effective work habits including, regular and prompt attendance, dependability, teamwork and initiative required.

About Us

Build your career with us

At Huntsville Hospital, Huntsville Hospital for Women & Children and Madison Hospital, you’ll find meaningful work, supportive teams and opportunities to grow within a locally governed, nonprofit health system committed to the communities we serve. Our workplace culture has earned national recognition, including Newsweek’s America’s Greatest Workplaces in Health Care 2026 and Forbes’ America’s Best-in-State Employers 2025.
Huntsville Hospital is the region’s primary referral center for advanced and specialty care, home to a specialized Orthopedic & Spine Tower, a Level III Regional Neonatal ICU and North Alabama’s Level I Trauma Center. Together, our three Madison County hospitals have 971 licensed beds and offer career opportunities across a wide range of specialties and care settings.
Employees have access to continuing education, Shared Governance, Clinical Ladder, Nurse Residency, tuition assistance, child care, wellness resources, an on-site employee pharmacy and health clinic, and more. We are proud to be an equal opportunity employer and a partner in the U.S. Army Partnership for Your Success (PaYS) Program.

Huntsville Hospital Benefits:

We are committed to providing competitive benefits. Our benefits package for eligible employees includes medical, dental, vision, life insurance, flexible spending; short term and long term disability; several retirement account options with 401Korganization match; nurse residency program; tuition assistance; student loan reimbursement; On-site training and education opportunities; Employee Discountsto phone providers, local restaurants, tickets to shows, apartment application and much more!

Learn more about Huntsville Hospital Health System:

• Careers: https://careers.hhsys.org/careers-home
• Benefits: https://careers.hhsys.org/why-hh-health/benefits/benefits-at-huntsville-hospital/
• Education & Professional Development: https://www.huntsvillehospital.org/education
• Life In Huntsville: https://www.huntsvillehospital.org/about-huntsville-al