Precertification/Authorization Specialist

Medical University of South Carolina; Charleston (SC); In loco; USD 25.000 - 39.000; Tempo pieno

Vantaggi offerti da questo lavoro

Health insurance

Dental insurance

Vision insurance

Life insurance

Retirement plan

Paid time off

Parental leave

Disability insurance

Training and development

Competitive pay and merit increase

Wellbeing resources

Tuition reimbursement

Employee discounts

Referral program

Flexible schedule

Certification incentive program

Descrizione del lavoro

The Medical University of South Carolina is seeking a Precertification Specialist to verify eligibility, obtain insurance benefits, and ensure pre-certification, authorization, and referral requirements are met prior to the delivery of inpatient, outpatient, and ancillary services.

This role coordinates with payers and clinical partners to obtain necessary authorizations and documents details in patient records.

Competenze

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

Mansioni

• Verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to delivering inpatient, outpatient, and ancillary services.
• Determine which patient services have third party payer requirements and obtain necessary authorizations via phone, fax, or payer websites.
• Provide detailed and timely communication to payers and clinical partners to facilitate compliance with payer requirements and document information in patient records.
• Other duties as assigned.

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.

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

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.

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!

The 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.

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

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