Pre-Certification Specialist

Black Women's Mental Health Institute; Columbus (OH); On-site; USD 25,000 - 33,000; Full time

Job summary

Black Women's Mental Health Institute is seeking a detail-oriented professional to obtain insurance authorizations and verify patient benefits for procedures, diagnostic testing, and specialty services. You will review clinical documentation, submit requests to payers, and track outcomes to ensure timely decisions.

In this role, you will support appeals when denials occur, communicate results to patients and care teams, and maintain accurate records while coordinating with scheduling, clinical,

Qualifications

• Strong knowledge of insurance authorization and benefits verification processes.
• Attention to detail in reviewing and managing clinical documentation.
• Excellent communication skills for patient and internal team updates.
• Ability to track requests, resolve issues, and support appeals effectively.
• Proficiency in maintaining organized records and coordinating across departments.

Responsibilities

• Review clinical documentation to determine authorization needs.
• Submit authorization and benefit verification requests to payers.
• Track submission status and ensure timely follow-up on decisions.
• Support and assist with appeals when authorization is denied or incomplete.
• Communicate authorization outcomes and benefit details to patients and care teams.
• Maintain accurate, up-to-date authorization and benefits records.
• Coordinate with scheduling, clinical, and billing departments to ensure seamless documentation flow.

Skills

Insurance authorization

Benefits verification

Documentation review

Patient communication

Interdepartmental coordination

Job description

Role Summary

Responsible for obtaining insurance authorizations and verifying patient benefits for procedures, diagnostic testing, and specialty services.

• Review clinical documentation to determine authorization needs.
• Submit authorization and benefit verification requests to payers.
• Track submission status and ensure timely follow-up on decisions.
• Support and assist with appeals when authorization is denied or incomplete.
• Communicate authorization outcomes and benefit details to patients and care teams.
• Maintain accurate, up-to-date authorization and benefits records.
• Coordinate with scheduling, clinical, and billing departments to ensure seamless documentation flow.

Role Summary

Responsible for obtaining insurance authorizations and verifying patient benefits for procedures, diagnostic testing, and specialty services.

• Review clinical documentation to determine authorization needs.
• Submit authorization and benefit verification requests to payers.
• Track submission status and ensure timely follow-up on decisions.
• Support and assist with appeals when authorization is denied or incomplete.
• Communicate authorization outcomes and benefit details to patients and care teams.
• Maintain accurate, up-to-date authorization and benefits records.
• Coordinate with scheduling, clinical, and billing departments to ensure seamless documentation flow.

Key Skills & Qualifications

• Strong knowledge of insurance authorization and benefits verification processes.
• Attention to detail in reviewing and managing clinical documentation.
• Excellent communication skills for patient and internal team updates.
• Ability to track requests, resolve issues, and support appeals effectively.
• Proficiency in maintaining organized records and coordinating across departments.