Precertification Representative

Stamford Health • Stamford, CT

6d • Onsite

About The Position

The Precertification Representative performs insurance verification and eligibility processes for ordered or scheduled therapeutic procedures, medications, surgeries, and diagnostic testing. The role uses the practice management system, electronic eligibility tools, reports, payer websites, and telephone contacts with insurance customer service representatives. The representative ensures insurance, demographic, and eligibility information is collected and accurately entered according to Practice policies and procedures; communicates with patients to obtain missing information and make corrections; and contacts insurance companies to initiate and complete required pre-certification or authorization processes.

The position is based at the medical office building at 29 Hospital Plaza in Stamford. It is a regular, full-time role with a schedule of 8:00 a.m.–4:30 p.m. or 8:30 a.m.–5:00 p.m. The role supports Stamford Health’s commitment to compassionate, personalized, person-centered care and a respectful, collaborative environment aligned with its Planetree philosophy.

Requirements

• High school diploma or General Education Development (GED).
• 1–2 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 computer 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 for ordered or scheduled therapeutic procedures, medications, surgeries, and diagnostic testing.
• Use the practice management system, automated electronic eligibility functionality, reports, payer websites, and telephone contacts with insurance customer service representatives.
• Obtain and accurately enter insurance, demographic, and eligibility information according to 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 patients to initiate and complete required pre-certification or authorization processes.

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
• Education Level: High school or GED