Pre-Certification Specialist (3077)

TRINITY HEALTH • Minot, ND

5d • $19 - $28

About The Position

The Pre-Certification Specialist verifies patient insurance benefits and secures required authorizations to support the timely and compliant delivery of clinical services at Trinity Health. This role reviews payer guidelines, coordinates closely with clinical departments, and communicates with insurance companies to ensure hospital stays and outpatient services are authorized appropriately. Working as part of a collaborative revenue cycle and care coordination team, the Pre-Certification Specialist helps minimize reimbursement risk by obtaining accurate and complete pre certifications. Through attention to detail, clear communication, and dependable follow-through, this position contributes to efficient operations and supports a positive patient experience by ensuring financial processes are handled promptly and accurately.

Requirements

• None
• High School diploma or equivalent preferred.
• Experience with third party payer billing regulations, reimbursement requirements, precertification, insurance eligibility verification, and/or utilization management is preferred.
• Working knowledge of CPT/ICD10 and medical terminology is preferred.
• Demonstrated advanced communication and interpersonal skills with all levels of internal and external customers.
• Self directed, attention to detail.
• Computer experience.
• Ability to navigate numerous websites for eligibility and prior authorization.
• Working knowledge of Microsoft Office Suite applications including Outlook, Word and Excel.
• Excellent written and oral communication skills.
• Ability to handle high workload volume.
• Must be flexible and demonstrate ability to be adaptable.

Responsibilities

• Verify insurance eligibility and coverage for scheduled and unscheduled services using payer websites, electronic systems, and direct communication with insurance representatives.
• Obtain required authorizations for inpatient admissions, extended stays, outpatient procedures, and diagnostic testing in accordance with each payer’s rules.
• Document authorization details accurately and promptly in the appropriate Trinity Health systems to support billing and clinical workflows.
• Communicate with clinical departments, schedulers, providers, and the Business Office to clarify requirements and resolve authorization-related issues.
• Monitor high-volume workloads, prioritize tasks, and follow up on pending authorizations to ensure timely completion.
• Maintain working knowledge of payer policies, CPT/ICD-10 coding concepts, and medical terminology to support accurate precertification activities.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 501-1,000 employees