Precertification/Authorization Specialist

Medical University of South Carolina • Charleston, SC

1d • Onsite

About The Position

Responsible for verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to the delivery of inpatient, outpatient, and ancillary services. This individual determines which patient services have third party payer requirements and is responsible for obtaining the necessary authorizations for care, via phone, fax, or payer websites. The Specialist provides detailed and timely communication to both payers and clinical partners in order to facilitate compliance with payer contractual requirements and is responsible for documenting the appropriate information in the patient's record. Other duties as assigned.

Requirements

• High School Degree or Equivalent
• 1 year of work experience

Responsibilities

• Verifying eligibility
• Obtaining insurance benefits
• Ensuring pre-certification, authorization, and referral requirements are met prior to the delivery of inpatient, outpatient, and ancillary services
• Determining which patient services have third party payer requirements
• Obtaining the necessary authorizations for care, via phone, fax, or payer websites
• Providing detailed and timely communication to both payers and clinical partners in order to facilitate compliance with payer contractual requirements
• Documenting the appropriate information in the patient's record
• Other duties as assigned

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED