Remote Precertification Specialist: Prior Auth & Benefits

Paycom - ATS

Huntersville (NC)

Hybrid

USD 42,000 - 64,000

Full time

7 days ago

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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 remote/hybrid role requires accuracy in entering pre-payments and clear communication with patients and provider offices.

You will monitor work queues, follow payer guidelines, and escalate issues as needed to ensure services are authorized and financially cleared before

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.
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.
Monitor emails, in-basket messages, voicemails, and scanned faxes daily.
Identify potential systemic or payer-related issues and escalate them to leadership as appropriate.