Precertification Representative

A company is looking for a Precertification and Authorization Representative-Remote. Key Responsibilities Resolve referral, precertification, and prior authorization for various insurance plans across hospital and clinic settings Conduct pre-appointment insurance reviews and manage denials recovery functions Adhere to quality assurance guidelines and productivity standards to meet performance expectations Required Qualifications, Training, and Education High School Diploma or GED with 2+ years of relevant experience, or a Bachelor's degree General knowledge of healthcare terminology and CPT-ICD10 codes Basic knowledge of insurance verification and claim adjudication preferred Experience using an Epic RC/EMR system is preferred Healthcare Financial Management Association (HFMA) Certification preferred

Apr 2, 2025 - 20:42

A company is looking for a Precertification and Authorization Representative-Remote. Key Responsibilities Resolve referral, precertification, and prior authorization for various insurance plans across hospital and clinic settings Conduct pre-appointment insurance reviews and manage denials recovery functions Adhere to quality assurance guidelines and productivity standards to meet performance expectations Required Qualifications, Training, and Education High School Diploma or GED with 2+ years of relevant experience, or a Bachelor's degree General knowledge of healthcare terminology and CPT-ICD10 codes Basic knowledge of insurance verification and claim adjudication preferred Experience using an Epic RC/EMR system is preferred Healthcare Financial Management Association (HFMA) Certification preferred