Precertification & Benefits Specialist

Borland Groover; Jacksonville (FL); On-site; USD 38,000 - 54,000; Full time

Job summary

Borland Groover is seeking a Precertification Specialist to join the Patient Access department in Jacksonville. The role ensures referrals and/or authorizations are secured so clinics and ambulatory surgical centers are reimbursed for services rendered.

Responsibilities include verifying eligibility, obtaining referrals and precertifications, handling patient inquiries, and coordinating with insurance providers to cover procedures. HIPAA training is required and compliance must be maintained.

Qualifications

• Able to communicate effectively with patients and staff in writing and verbally.
• Ability to manage multiple tasks in a possibly stressful environment.
• Strong attention to detail and accuracy in processing referrals and authorizations.

Responsibilities

• Verify benefits and/or eligibility of patients to be seen.
• Obtain referrals as needed before physician visits.
• Obtain precertifications before tests and procedures.
• Answer calls from patients to explain insurance requirements or schedule appointments.
• Conduct outbound calls to patients as needed.
• Process payment arrangements for patients when necessary.
• Contact insurance companies to inquire about benefits or authorizations.
• Assist satellite office staff with insurance or precertification understanding.
• Address nurse or patient portal inquiries for the department.

Skills

Communication

Time management

Critical thinking

Compassion

Education

High school diploma

Job description

Borland Groover is seeking a Precertification Specialist to join the Patient Access department in Jacksonville. The role ensures referrals and/or authorizations are secured so clinics and ambulatory surgical centers are reimbursed for services rendered.

Responsibilities include verifying eligibility, obtaining referrals and precertifications, handling patient inquiries, and coordinating with insurance providers to cover procedures. HIPAA training is required and compliance must be maintained.