Precertification & Authorization Specialist

MUSC Health; Charleston (SC); On-site; USD 30,000 - 47,000; Full time

Benefits offered by this job

Health, dental, vision, and life保险

Employer Sponsored Retirement Plan

Paid time off and extended sick leave

Paid Parental Leave

Disability insurance plan options

Continuous professional and clinical培训

Competitive pay

Annual Merit Increase

Wellbeing resources

Tuition Reimbursement

Employee perks and discounts

Employee referral program

Flexible schedule option

Certification incentive program

Job summary

MUSC Health in Charleston, SC is seeking a Precertification Specialist to verify patient eligibility, obtain insurance benefits, and ensure all pre-certification, authorization and referral requirements are met before delivering inpatient, outpatient, and ancillary services.

The role requires coordinating with payers and clinical partners, determining which services require third-party authorizations, and documenting information in the patient record.

Qualifications

• High School Diploma or GED required; 1 year experience preferred.
• Ability to obtain authorizations via phone, fax or payer websites.

Responsibilities

• Verify eligibility and obtain insurance benefits prior to services.
• Ensure pre-certification, authorization and referral requirements are met for inpatient, outpatient and ancillary services.
• Identify services with third-party payer requirements and obtain necessary authorizations.
• Provide detailed, timely communication to payers and clinical partners.
• Document all information in the patient’s record.
• Other duties as assigned.

Skills

Verifying eligibility

Obtaining insurance benefits

Authorization handling

Referral management

Payer communication

Documentation in patient records

Education

High School Diploma or GED

Job description

MUSC Health in Charleston, SC is seeking a Precertification Specialist to verify patient eligibility, obtain insurance benefits, and ensure all pre-certification, authorization and referral requirements are met before delivering inpatient, outpatient, and ancillary services.

The role requires coordinating with payers and clinical partners, determining which services require third-party authorizations, and documenting information in the patient record.