Pre-Certification & Insurance Verification Specialist

CharterCARE Health Partners; Providence (RI); On-site; USD 40,000 - 60,000; Full time

Job summary

CharterCARE Health Partners is seeking a Pre-Certification Specialist in Providence, Rhode Island. The role involves obtaining authorizations prior to treatments in the Cancer Center, verifying patient insurance coverage, and ensuring compliance with various payer guidelines. Candidates should have a high school diploma or GED, with a preference for an associate's degree, and 2-3 years of experience in insurance verification. Strong communication and organizational skills are crucial for success in this fast-paced environment.

Qualifications

• 2–3 years of insurance verification and preauthorization experience in healthcare.
• Knowledge of CPT, ICD-10 coding and J codes.
• Understanding of insurance coverages and reimbursement practices.

Responsibilities

• Obtain necessary authorizations prior to treatments in the Cancer Center.
• Verify patient insurance coverage and benefit levels.
• Track all authorizations and pre-certifications as required.

Skills

Strong verbal and written communication skills

Strong computer skills

Ability to work independently and in a team

Organizational skills

Proficient with Microsoft Office

Education

High school graduate or GED

Associate's level degree preferred

Job description

CharterCARE Health Partners is seeking a Pre-Certification Specialist in Providence, Rhode Island. The role involves obtaining authorizations prior to treatments in the Cancer Center, verifying patient insurance coverage, and ensuring compliance with various payer guidelines. Candidates should have a high school diploma or GED, with a preference for an associate's degree, and 2-3 years of experience in insurance verification. Strong communication and organizational skills are crucial for success in this fast-paced environment.