Pre-Certification & Authorization Specialist

Premier Health; Moraine (OH); On-site; USD 42,000 - 56,000; Full time

Job summary

System Support in Moraine, OH is seeking a Pre-Certification Specialist to complete pre-certification, prior authorization and payer notifications for elective procedures. You will communicate with insurers and physician offices to secure authorizations while ensuring compliance with regulatory requirements and protecting patient privacy.

The role emphasizes strong customer service, clear communication, and the ability to manage multiple tasks in a busy healthcare office environment.

Qualifications

• Education: High school diploma or GED required.
• Associate Degree in related healthcare or business field preferred.
• Two years of Patient Access, Health Information Management, Physician Office, Billing, Collections or Compliance experience required.
• Two Years of previous insurance experience and/or pre-certification experience preferred.
• Demonstrate knowledge of medical terminology and basic anatomy/physiology.

Responsibilities

• Complete pre-certification, prior authorization and notification for third party and government payers for all pre-scheduled procedures and testing.
• Communicate with insurance companies and/or physician offices to ensure pre-certifications are obtained.
• Maintain compliance with regulatory requirements and protect patient confidentiality.

Skills

Multi-tasking

Communication

Time management

Analytical skills

Windows OS

Typing 35 wpm

Telephone skills

Professional demeanor

Relationship building

Customer service

Education

High school diploma or GED

Associate degree preferred

Medical Terminology Certification preferred

Job description

System Support in Moraine, OH is seeking a Pre-Certification Specialist to complete pre-certification, prior authorization and payer notifications for elective procedures. You will communicate with insurers and physician offices to secure authorizations while ensuring compliance with regulatory requirements and protecting patient privacy.

The role emphasizes strong customer service, clear communication, and the ability to manage multiple tasks in a busy healthcare office environment.