Precertification/Authorization Specialist

C002 Medical University Hospital Authority (MUHA); United States; Presencial; USD 28.000 - 34.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health insurance

Dental and vision insurance

Employer-sponsored retirement plan

Paid time off

Paid parental leave

Disability insurance

Continued professional/clinical培训

Competitive pay

Annual merit increase

Wellbeing resources

Tuition reimbursement

Employee perks and discounts

Flexible schedule options

Certification incentive program

Descripción de la vacante

The Medical University of South Carolina is seeking a Precertification Specialist to verify patient eligibility and obtain insurance benefits prior to delivering inpatient, outpatient, and ancillary services. You will coordinate with payers and clinical teams, ensuring all referrals meet payer requirements and are accurately documented in the patient record.

You will communicate with payers and care partners via phone, fax, or payer portals, supporting compliant and timely approvals.

Formación

• High school diploma or equivalent is required.
• 1 year of work experience in healthcare or precertification is preferred.

Responsabilidades

• Verify patient eligibility and insurance benefits.
• Ensure pre-certification, authorization, and referral requirements are met for inpatient, outpatient, and ancillary services.
• Obtain authorizations via phone, fax, or payer websites.
• Communicate clearly with payers and clinical partners to ensure payer contract compliance.
• Document all relevant information in the patient record.
• Perform other duties as assigned.

Educación

High School Degree or Equivalent

Descripción del empleo

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 Work Shift

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.

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! 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. 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

Thank you for wanting to be part of the Medical University of South Carolina team. Whether you want to teach the next generation of health care leaders, innovate new business models, discover the next breakthrough or provide patient care, there's a role for you that fuels your passion and takes advantage of your skills. There are career opportunities available in academics, research, hospital medicine, physician practices and support services, from patient billing to IT. As an applicant, you can search jobs for all MUSC entities as well as search by category and location. MUSC attracts more than $250 million annually in research funding, making it the biggest magnet for biomedical, extramural research dollars of all institutions of higher learning in South Carolina. The Clinical and Translational Science Award (CTSA) Program aims to advance clinical and translational science to increase the speed at which new treatments become available to patients. MUSC Health, the clinical enterprise, operates a 750 bed medical center, which includes a nationally recognized Children's Hospital, the Ashley River Tower (cardiovascular, digestive disease, and surgical oncology), Hollings Cancer Center (one of fewer than 70 elite National Cancer Institute designated centers), a Level I Trauma Center and the Institute of Psychiatry. In addition, there are more than 100 outreach clinics, hospital/health system affiliations, and telehealth sites. U.S. News & World Report placed us among the top one percent of all American hospitals, with 11 specialties in the top 50. The MUSC Medical Center is also one of only three Magnet® designated hospitals in South Carolina.