Precertification Specialist- Retina (48231)

Charlotte Eye Ear Nose & Throat Associates, P.A. (CEENTA); Huntersville (NC); Hybrid; USD 52,000 - 62,000; Full time

Job summary

CEENTA is seeking a detail-oriented Precertification Specialist to support our Revenue Cycle team by verifying insurance benefits, obtaining prior authorizations, and ensuring patients are well informed prior to services.

This hybrid remote role supports 40 hours per week with a schedule of 7:00 a.m. to 6:00 p.m., Monday through Friday. The ideal candidate has at least 2 years in a medical setting and precertification experience; Epic experience is preferred but not required.

Qualifications

• High school diploma or GED required.
• Minimum of 2 years of experience in a medical field.
• At least 1 year of precertification or prior authorization experience preferred.
• Understanding of payer medical policies and prior authorization guidelines.
• Excellent customer service and communication skills.
• Ability to multitask, problem-solve, and work independently.
• Epic experience preferred but not required.

Responsibilities

• Verify and confirm patient insurance benefits via online portals and phone calls.
• Obtain prior authorizations and referrals as required by payer plans, with ongoing follow-up when needed.
• Communicate benefit details, coverage, and expected pre-payments clearly to patients.
• Communicate with provider offices and internal teams to resolve authorization and benefit issues.
• Enter patient pre-payments into Epic accurately and timely.
• Prioritize assigned work queues by date of service, payer, and procedural requirements.
• Monitor emails, in-basket messages, voicemails, and scanned faxes daily.
• Identify potential systemic or payer-related issues and elevate them to leadership as appropriate.

Skills

Attention to detail

Customer service

Communication

Multitasking

Education

High school diploma or GED

Tools

Epic

Job description

Precertification Specialist

Why Join CEENTA?

CEENTA is the premier eye, ear, nose, and throat group in the Carolinas, committed to exceptional patient care, operational excellence, and a collaborative team environment.

We are seeking a detail-oriented Precertification Specialist to support our Revenue Cycle team by verifying insurance benefits, obtaining prior authorizations, and ensuring patients are well informed prior to services.

What You Will Do

• Verify and confirm patient insurance benefits via online portals and phone calls
• Obtain prior authorizations and referrals as required by payer plans, with ongoing follow-up when needed
• Communicate benefit details, coverage, and expected pre-payments clearly to patients
• Communicate with provider offices and internal teams to resolve authorization and benefit issues
• Enter patient pre-payments into Epic accurately and timely
• Prioritize assigned work queues by date of service, payer, and procedural requirements
• Monitor emails, in-basket messages, voicemails, and scanned faxes daily
• Identify potential systemic or payer-related issues and elevate them to leadership as appropriate

A Typical Day

Monitor authorization and benefit verification work queues, contact payers, communicate with patients regarding pre-service payments, respond to emails and in-basket messages, process incoming faxes, and collaborate with provider offices to ensure all scheduled services are authorized and financially cleared prior to the date of service.

Schedule

Hybrid/Remote, Full-time, 40 hours per week. Monday-Friday with hours ranging between 7:00 a.m. and 6:00 p.m.

Work Environment

Remote/Home Office environment. Employees must have a dedicated, HIPAA-compliant workspace with high-speed internet and sufficient space for two monitors. The ability to work independently, manage time effectively, and remain productive in a remote setting is required.

Travel

Travel is not required for this position, except for training or occasional in-person staff meetings as needed.

Qualifications

What You'll Bring

• High school diploma or GED required
• Minimum of 2 years of experience in a medical field
• At least 1 year of precertification or prior authorization experience preferred
• Understanding of payer medical policies and prior authorization guidelines
• Strong attention to detail and ability to manage a high-volume, time-sensitive workload
• Excellent customer service and communication skills
• Ability to multitask, problem-solve, and work independently
• Epic experience preferred but not required