Precertification Specialist

MUSC; Orleans Estates (SC); Presencial; USD 25.000 - 39.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Retirement Plan

Paid Time Off

Sick Leave

Parental Leave

Disability Insurance

Professional Training

Competitive Pay

Merit Increase

Wellbeing Resources

Tuition Reimbursement

Employee Discounts

Referral Program

Flexible Schedule

Certification Incentive

Descripción de la vacante

Medical University of South Carolina is seeking a Precertification Specialist to verify eligibility and obtain insurance benefits before inpatient, outpatient, and ancillary services. The role involves determining payer requirements and securing necessary authorizations via phone, fax, or payer portals, with careful documentation in patient records.

Earn 40 hours weekly in an on-site position, with benefits including health/dental/vision, retirement, paid time off, parental leave, and

Formación

• High school diploma or equivalent required.
• Minimum 1 year of work experience in precertification or insurance.
• Ability to secure authorizations for care and manage payer requirements.
• Strong communication with payers and clinical partners.

Responsabilidades

• Verify eligibility and obtain insurance benefits before services.
• Ensure pre-certification, authorization, and referral requirements are met.
• Determine payer requirements and obtain necessary authorizations via phone, fax, or portals.
• Provide timely communication to payers and clinical partners and document in patient records.
• Perform other duties as assigned.

Conocimientos

Eligibility verification

Insurance benefits handling

Payer communication

Documentation in patient records

Educación

High School Diploma or Equivalent

Descripción del empleo

Job Description Summary

This role is 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

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 option
• 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