Precertification/Authoriation Specialist

C018 MUSC Community Physicians (MCP); United States; On-site; USD 25,000 - 39,000; Full time

Benefits offered by this job

Health insurance

Retirement plan

Paid time off

Tuition reimbursement

Parental leave

Disability insurance

Flexible schedule

Certification incentive program

Employee referral program

Job summary

Medical University of South Carolina is seeking a benefits and eligibility specialist responsible for verifying patient eligibility, confirming insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to services.

The role involves coordinating with payers and clinical partners, documenting information in patient records, and performing additional duties as assigned.

Qualifications

• Education: High School Degree or Equivalent.
• Work Experience: 1 year.

Responsibilities

• Verify eligibility and obtain insurance benefits before services.
• Ensure pre-certification, authorization, and referrals are met for inpatient, outpatient, and ancillary services.
• Obtain authorizations for care via phone, fax, or payer websites and communicate with payers and clinical partners.
• Document all required information in the patient record and perform other duties as assigned.

Education

High School Degree or Equivalent

Job description

Job Summary

Responsible for verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to the delivery of inpatient, outpatient, and ancillary services.

Entity MUSC Community Physicians (MCP) Worker Type Employee Worker Sub-Type Regular Cost Center CC004513 MCP - Revenue Cycle Pay Rate Type Hourly Pay Grade Health-20 Scheduled Weekly Hours 40 Work Shift

Job Description

• Responsible for verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to the delivery of inpatient, outpatient, and ancillary services.
• This individual determines which patient services have third party payer requirements and is responsible for obtaining the necessary authorizations for care, via phone, fax, or payer websites.
• The Specialist provides detailed and timely communication to both payers and clinical partners in order to facilitate compliance with payer contractual requirements and is responsible for documenting the appropriate information in the patient's record.
• Other duties as assigned.

Education and Experience

• Education: High School Degree or Equivalent
• Work Experience: 1 year

Benefits and Incentives

• Health, dental, vision, and life insurance
• Employer Sponsored Retirement Plan
• Paid time off and extended sick leave
• Paid Parental Leave
• Disability insurance plan options
• Continuous professional and clinical training
• Competitive pay
• Annual Merit Increase
• Wellbeing resources
• Tuition Reimbursement
• Employee perks and discounts
• Employee referral program
• Flexible schedule options
• Certification incentive program

If you like working with energetic enthusiastic individuals, you will enjoy your career with us!

Equal Opportunity Employer

Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.

Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: http://www.uscis.gov/e-verify/employees

Thank you for wanting to be part of the Medical University of South Carolina team. Whether you want to teach the next generation of health care leaders, innovate new business models, discover the next breakthrough or provide patient care, there's a role for you that fuels your passion and takes advantage of your skills. There are career opportunities available in academics, research, hospital medicine, physician practices and support services, from patient billing to IT. As an applicant, you can search jobs for all MUSC entities as well as search by category and location. MUSC attracts more than $250 million annually in research funding, making it the biggest magnet for biomedical, extramural research dollars of all institutions of higher learning in South Carolina. The Clinical and Translational Science Award (CTSA) Program aims to advance clinical and translational science to increase the speed at which new treatments become available to patients. MUSC Health, the clinical enterprise, operates a 750 bed medical center, which includes a nationally recognized Children's Hospital, the Ashley River Tower (cardiovascular, digestive disease, and surgical oncology), Hollings Cancer Center (one of fewer than 70 elite National Cancer Institute designated centers), a Level I Trauma Center and the Institute of Psychiatry. In addition, there are more than 100 outreach clinics, hospital/health system affiliations, and telehealth sites. U.S. News & World Report placed us among the top one percent of all American hospitals, with 11 specialties in the top 50. The MUSC Medical Center is also one of only three Magnet designated hospitals in South Carolina.