Precertification Specialist

Cataract and Laser Institute•Wabash, IN

1d•Onsite

About The Position

Cataract & Laser Institute is seeking a detail-oriented and dependable Precertification Specialist to join our team. In this role, you will help ensure patients receive timely access to surgical care by coordinating insurance eligibility, benefits, precertifications, and prior authorizations. You will serve as an important connection between patients, providers, surgical teams, clinic staff, and insurance companies—helping create a seamless, compassionate, and efficient experience from scheduling through surgery.

Requirements

High school diploma or equivalent required
Previous experience with insurance verification, prior authorizations, precertification, medical billing, or healthcare administration preferred.
Knowledge of medical terminology, insurance plans, CPT codes, and ICD-10 codes preferred.
Strong attention to detail and a commitment to maintaining accurate documentation.
Excellent organizational, time-management, and problem-solving skills.
Ability to prioritize multiple requests and meet deadlines in a fast-paced environment.
Strong written and verbal communication skills.
Comfortable communicating with patients, insurance representatives, providers, and clinical teams.
Proficiency with electronic medical records, Microsoft Office, and other healthcare-related systems.
Ability to work independently while contributing to a collaborative team environment.

Nice To Haves

associate degree in healthcare administration or a related field preferred.

Responsibilities

Obtain insurance precertifications and prior authorizations for surgical procedures.
Verify patients’ insurance eligibility, benefits, coverage requirements, and financial responsibility.
Review scheduled procedures and supporting clinical documentation to ensure payer requirements are met.
Submit accurate authorization requests with the appropriate medical records and supporting documentation.
Communicate with insurance companies regarding authorization status, additional documentation requests, denials, and appeals.
Coordinate with surgeons, surgical schedulers, clinic teams, billing staff, and patients to resolve authorization or coverage concerns.
Maintain accurate and timely documentation within the electronic medical record and other applicable systems.
Monitor pending authorizations, expiration dates, and renewal requirements to prevent delays or cancellations.
Assist with resolving denied or delayed authorization requests.
Stay informed of payer-specific guidelines, authorization requirements, and regulatory changes.
Protect patient confidentiality and maintain compliance with HIPAA and organizational policies.
Provide professional, compassionate service when communicating with patients and internal teams.