Precertification Specialist

Bridgeview Eye Partners; Wabash (IN); On-site; USD 40,000 - 52,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

401(k) with company match

Paid time off and paid holidays

Company-paid life insurance

Supportive, team-focused environment

Job summary

Cataract & Laser Institute is seeking a detail-oriented Precertification Specialist to coordinate insurance eligibility, precertifications, and authorizations, ensuring timely access to surgical care. You will liaise with patients, providers, surgical teams, clinic staff, and insurers to maintain a smooth patient journey from scheduling through surgery.

Responsibilities include verifying benefits, submitting requests with supporting records, tracking expiration dates, and addressing denials.

Qualifications

• Experience with insurance verification and precertification workflow.
• Knowledge of CPT and ICD-10 codes preferred.
• Ability to maintain accurate documentation and comply with HIPAA.

Responsibilities

• Obtain insurance precertifications and prior authorizations for surgical procedures.
• Verify eligibility, benefits, coverage requirements, and financial responsibility.
• Review procedures and documentation to meet payer requirements.
• Submit authorization requests with medical records and documentation.
• Communicate with insurance companies about status, denials, and appeals.
• Coordinate with surgeons, schedulers, clinic staff, billing, and patients.
• Maintain documentation in the EMR and other systems.
• Monitor authorizations, expiration dates, and renewals.
• Assist with resolving denied or delayed requests.
• Stay informed of payer guidelines and regulatory changes.
• Protect patient confidentiality and HIPAA compliance.
• Provide professional, compassionate service when communicating with patients and teams.

Skills

Insurance verification

Precertification

Prior authorizations

Medical billing

Healthcare administration

Attention to detail

Communication

Education

High school diploma or equivalent

Associate degree in healthcare administration preferred

Tools

Electronic Medical Records (EMR)

Microsoft Office

Healthcare systems

Job description

Cataract & Laser Institute is seeking a detail-oriented and dependable Precertification Specialist to join our team. In this role, you will help ensure patients receive timely access to surgical care by coordinating insurance eligibility, benefits, precertifications, and prior authorizations.

You will serve as an important connection between patients, providers, surgical teams, clinic staff, and insurance companies—helping create a seamless, compassionate, and efficient experience from scheduling through surgery.

What You’ll Do

• Obtain insurance precertifications and prior authorizations for surgical procedures.
• Verify patients’ insurance eligibility, benefits, coverage requirements, and financial responsibility.
• Review scheduled procedures and supporting clinical documentation to ensure payer requirements are met.
• Submit accurate authorization requests with the appropriate medical records and supporting documentation.
• Communicate with insurance companies regarding authorization status, additional documentation requests, denials, and appeals.
• Coordinate with surgeons, surgical schedulers, clinic teams, billing staff, and patients to resolve authorization or coverage concerns.
• Maintain accurate and timely documentation within the electronic medical record and other applicable systems.
• Monitor pending authorizations, expiration dates, and renewal requirements to prevent delays or cancellations.
• Assist with resolving denied or delayed authorization requests.
• Stay informed of payer-specific guidelines, authorization requirements, and regulatory changes.
• Protect patient confidentiality and maintain compliance with HIPAA and organizational policies.
• Provide professional, compassionate service when communicating with patients and internal teams.

What We’re Looking For

• High school diploma or equivalent required; associate degree in healthcare administration or a related field preferred.
• Previous experience with insurance verification, prior authorizations, precertification, medical billing, or healthcare administration preferred.
• Knowledge of medical terminology, insurance plans, CPT codes, and ICD-10 codes preferred.
• Strong attention to detail and a commitment to maintaining accurate documentation.
• Excellent organizational, time-management, and problem-solving skills.
• Ability to prioritize multiple requests and meet deadlines in a fast-paced environment.
• Strong written and verbal communication skills.
• Comfortable communicating with patients, insurance representatives, providers, and clinical teams.
• Proficiency with electronic medical records, Microsoft Office, and other healthcare-related systems.
• Ability to work independently while contributing to a collaborative team environment.

Why Join Cataract & Laser Institute?

• Competitive compensation
• Medical, dental, and vision insurance
• 401(k) with company match
• Paid time off and paid holidays
• Company-paid life insurance
• Supportive and team-focused work environment
• Opportunities to develop your knowledge and grow within the organization
  

  PHYSICAL DEMANDS AND WORK ENVIRONMENT (per ADA guidelines):

  • Physical Activity: Standing for sustained periods of time, Stooping, Grasping, Lifting, Talking, Hearing.
  • Physical requirements: Light work. Must be able to lift up to 15 lbs on a regular basis from floor to waist, 5 lbs from waist to shoulder, and 5 lbs from shoulder to overhead.
  • The worker is required to have close visual acuity to perform each activity.
  • The worker may be exposed to the following hazards:
  • Blood borne pathogens
  • Communicable diseases
  • Chemicals
  • Steam
  • Pressurized cylinders
  • Sharp objects
  • Moving parts of equipment

Make an Impact

As a Surgical Precertification Specialist, your accuracy, persistence, and communication will directly support our patients and surgical teams. By helping resolve insurance requirements before the day of surgery, you will reduce delays, improve the patient experience, and help ensure each patient receives the care they need.

Cataract & Laser Institute is an Equal Opportunity Employer.

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.