Precertification/Authorization Specialist

Medical University of South Carolina • Charleston, SC

2d

About The Position

Responsible for verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met before inpatient, outpatient, and ancillary services are delivered. Determines which patient services have third-party payer requirements and obtains necessary authorizations through phone, fax, or payer websites. Provides timely, detailed communication to payers and clinical partners to support compliance with payer contractual requirements, and documents appropriate information in the patient’s record. Performs other duties as assigned.

Requirements

• High school degree or equivalent.
• One year of work experience.

Responsibilities

• Verify patient eligibility and obtain insurance benefits.
• Ensure pre-certification, authorization, and referral requirements are met before services are delivered.
• Determine which patient services have third-party payer requirements.
• Obtain required authorizations by phone, fax, or payer websites.
• Communicate timely and detailed information to payers and clinical partners to facilitate compliance with payer contractual requirements.
• Document appropriate information in the patient’s record.
• Perform other duties as assigned.

Benefits

• Health, dental, vision, and life insurance
• Employer-sponsored retirement plan
• Paid time off and extended sick leave
• Paid parental leave
• Disability insurance plan options
• Continuous professional and clinical training
• Competitive pay
• Annual merit increase
• Wellbeing resources
• Tuition reimbursement
• Employee perks and discounts
• Employee referral program
• Flexible schedule options
• Certification incentive program

What This Job Offers

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