Pre-Certification & Prior Authorization Specialist

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

Job summary

Premier Health Partners seeks a Pre-Certification Specialist to complete pre-certification, prior authorization and notification for third party and government payers for all pre-scheduled elective inpatient/outpatient procedures and diagnostic testing.

The role involves communicating with insurance companies and physician offices to ensure timely pre-certifications and maintaining regulatory compliance while providing customer-focused service in a busy clinical setting.

Qualifications

• Education: High school diploma or GED required. Associate Degree in related healthcare or business field preferred.
• Licensure: N/A
• Certification: Medical Terminology Certification preferred.

Responsibilities

• Complete pre-certification, prior authorization and notification for third party and government payers for all scheduled procedures.
• Communicate with insurance companies and physician offices to obtain pre-certifications.
• Maintain compliance with regulatory requirements.

Skills

Customer Focus

Functional/Technical Skills

Communication Skills

Multitasking

Time Management

Education

High school diploma or GED

Associate Degree preferred

Job description

Premier Health Partners seeks a Pre-Certification Specialist to complete pre-certification, prior authorization and notification for third party and government payers for all pre-scheduled elective inpatient/outpatient procedures and diagnostic testing.

The role involves communicating with insurance companies and physician offices to ensure timely pre-certifications and maintaining regulatory compliance while providing customer-focused service in a busy clinical setting.