Precertification Representative

Stamford Health • Stamford, CT

7d • Onsite

About The Position

The Precertification Representative performs insurance verification and eligibility processes for therapeutic procedures, medications, surgeries, and diagnostic testing. The role obtains and accurately enters insurance, demographic, and eligibility information; communicates with patients to obtain missing information and make corrections; and contacts insurers to initiate and complete required pre-certification or authorization processes. The position is based at Stamford Health’s medical office building at 29 Hospital Plaza in Stamford and follows a regular full-time schedule of 8:00 a.m.–4:30 p.m. or 8:30 a.m.–5:00 p.m.

Stamford Health emphasizes compassionate, personalized, person-centered care and a respectful, collaborative environment aligned with its Planetree philosophy.

Requirements

• High school diploma or GED.
• One to two years of previous insurance verification, pre-certification/pre-authorization, medical billing, or other related experience in a healthcare environment.
• High competency with computers, electronic medical records, the Internet, and software such as MS Office or equivalent.
• Knowledge of medical office operations, coding and billing, medical terminology, and third-party insurance processes.

Nice To Haves

• Clinical training.

Responsibilities

• Perform timely insurance verification and eligibility processes using the practice management system, automated electronic eligibility functionality, reports, third-party payer websites, and payer customer service telephone contacts for ordered or scheduled therapeutic procedures, medications, surgeries, and diagnostic testing.
• Obtain and accurately enter insurance, demographic, and eligibility information in the system in accordance with established Practice policies and procedures.
• Communicate with patients to identify missing information and make corrections as needed.
• Contact insurance companies on behalf of the Practice and the patient to initiate and complete required pre-certification or authorization processes for ordered procedures, surgeries, and diagnostic testing.

Benefits

• Competitive salary.
• Comprehensive, low-cost health insurance plans, including GLP-1 coverage options, available day one.
• Wellness programs.
• Paid Time Off accruals.
• Tax-deferred annuity and 403(b) pension plan.
• Tuition reimbursement.
• Free on-site parking and train station shuttle.
• Childcare partnership with Children’s Learning Center.

What This Job Offers

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