Precertification/Authorization Specialist

MUSC Health; Charleston (SC); In loco; USD 30.000 - 39.000; Tempo pieno

Vantaggi offerti da questo lavoro

Health, dental, vision, life insurance

Retirement plan

PTO and extended sick leave

Paid Parental Leave

Disability insurance

Training and development

Competitive pay

Annual merit increase

Wellbeing resources

Tuition reimbursement

Employee perks and discounts

Employee referral program

Flexible schedule

Certification incentives

Descrizione del lavoro

Medical University Hospital Authority (MUHA) in Charleston seeks a detail‑oriented Precertification Specialist. You will verify eligibility, obtain insurance benefits, and ensure pre-certification, authorization, and referral requirements are met for inpatient, outpatient, and ancillary services.

The role requires communicating with payers and clinical partners by phone, fax, or payer portals and documenting the relevant information in the patient record.

Competenze

• High School Degree or equivalent.
• Minimum 1 year of work experience.

Mansioni

• Verify eligibility and obtain insurance benefits.
• Ensure pre-certification, authorization, and referral requirements are met for services.
• Obtain authorizations via phone, fax, or payer websites.
• Document relevant information in the patient record and communicate with payers and clinical partners.

Formazione

High School Degree or Equivalent

Descrizione del lavoro

Job Description 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. 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.

Entity

Medical University Hospital Authority (MUHA)

Worker Type

Employee

Worker Sub-Type

Regular

Cost Center

CC002349 CHSCorp OH - Precertification Unit

Pay Rate Type

Hourly

Pay Grade

Health-20

Scheduled Weekly Hours

40

Job Description

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

Benefits

• 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!

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