Precertification & Authorization Specialist

Mercy Health Corporation; Janesville (WI); On-site; USD 24,000 - 36,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

Life Insurance

Paid time off

Tuition reimbursement

Job summary

Mercyhealth is seeking a dedicated Pre-Certification Specialist in Wisconsin to coordinate precertifications, gather required patient data, and liaise with insurance providers. The role emphasizes accuracy, timely follow-up, and adherence to payor requirements.

Qualifications include a high school diploma and 1 year of relevant healthcare experience; knowledge of Epic is preferred. Candidates should be able to work independently, handle stress, and communicate professionally.

Qualifications

• High school diploma or equivalent preferred.
• One year of pre-certifications, medical billing, registration, healthcare experience, or related education preferred.

Responsibilities

• Identify all scheduled patients requiring pre-certification or pre-determination.
• Identify all relevant patient data elements to acquire precertification.
• Contact insurance companies or employer groups to obtain pre-certifications and determine eligibility and benefits.
• Follow up on insurance issues to obtain financial resolution.
• Coordinate follow-up to ensure procedures are authorized and documented prior to service date.

Skills

Excellent oral communication skills

Ability to handle stress

Computer experience

Epic knowledge

Independent work

Education

High school diploma or equivalent

Tools

Epic

Job description

Mercyhealth is seeking a dedicated Pre-Certification Specialist in Wisconsin to coordinate precertifications, gather required patient data, and liaise with insurance providers. The role emphasizes accuracy, timely follow-up, and adherence to payor requirements.

Qualifications include a high school diploma and 1 year of relevant healthcare experience; knowledge of Epic is preferred. Candidates should be able to work independently, handle stress, and communicate professionally.