Precertification & Authorization Specialist

Mercy-Health-System-Corporation; Harvard (IL); On-site; USD 38,000 - 60,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Life Insurance

Paid time off

Parental leave

Education reimbursement

Job summary

Mercyhealth in Illinois is seeking a Pre-Certifications Coordinator to coordinate insurance pre-certifications and predeterminations, verify eligibility and benefits, collect necessary documentation, and support timely authorization and reimbursement. The role requires strong communication, organization, and computer skills; Epic experience is preferred.

A high school diploma is required and one year of healthcare or billing experience is preferred.

Qualifications

• Excellent oral communication and organizational skills.
• Ability to handle stress and problem solve.
• Computer experience required; familiarity with Epic preferred.
• Ability to work independently with minimal supervision; provide training and mentoring.

Responsibilities

• Identify all scheduled patients requiring pre-certification or pre-determination through various systems.
• Contact insurance companies or employer groups to obtain pre-certifications, predeterminations, and determine eligibility and benefits.
• Obtain necessary clinical documentation to use in the pre-certification process.
• Coordinate timely follow-up to ensure procedures are authorized and documented prior to the date of service.
• Meet department productivity and accuracy expectations; follow documentation standards on all patient encounters.

Skills

Oral communication

Organizational skills

Computer experience

Independent work

Training and mentoring

Epic knowledge

Education

High school diploma or equivalent

Tools

Epic

Job description

Mercyhealth in Illinois is seeking a Pre-Certifications Coordinator to coordinate insurance pre-certifications and predeterminations, verify eligibility and benefits, collect necessary documentation, and support timely authorization and reimbursement. The role requires strong communication, organization, and computer skills; Epic experience is preferred.

A high school diploma is required and one year of healthcare or billing experience is preferred.