Remote Pre-Certification Operations Manager

OneOncology; United States; Remote; USD 65,000 - 98,000; Full time

Job summary

OneOncology seeks a Manager, Pre-Certification to oversee the Pre-Cert team operations, ensuring timely eligibility verification, pre-cert and referrals, and accurate patient estimates. You will coordinate with vendor partners, monitor daily schedules, and audit cases for payer policy compliance to prevent care disruption and revenue loss.

As a leader, you will train staff, develop materials, stay current on payer requirements, and drive process improvements while supporting remote work and

Qualifications

• Minimum five (5) years Pre-Certification, Medical Front Office, or Medical Billing experience.
• Experience working from home or in a remote capacity is highly preferred.
• Strong customer service and leadership abilities.

Responsibilities

• Oversee daily Pre-Cert schedule with vendor partner and team for eligibility, benefits, Pre-Cert, and patient estimates.
• Ensure cases comply with payer policy and are completed timely and accurately.
• Manage workload distribution between vendor partner and Pre-Cert Coordinators.
• Lead point of contact with vendor partner and resolve cases at risk to avoid care disruption or revenue loss.
• Audit completed cases for proper procedures and correct patient estimates.
• Collaborate with Accounts Receivable on denials related to Pre-Cert cases.
• Develop training materials and update vendor on payer/procedure changes.
• Support remote staff and coordinate with provider offices to prevent disruptions.
• Continuously improve processes to enhance efficiency and quality.

Skills

Leadership

Communication

Time management

Attention to detail

Remote work

Medical terminology

Typing 40 WPM

Education

High School Diploma or GED

Tools

Medical billing software

ICD/CPT knowledge

Job description

OneOncology seeks a Manager, Pre-Certification to oversee the Pre-Cert team operations, ensuring timely eligibility verification, pre-cert and referrals, and accurate patient estimates. You will coordinate with vendor partners, monitor daily schedules, and audit cases for payer policy compliance to prevent care disruption and revenue loss.

As a leader, you will train staff, develop materials, stay current on payer requirements, and drive process improvements while supporting remote work and