Full-Time

Precertification/Authorization Specialist

Confirmed live in the last 24 hours

Medical University of South Carolina

Medical University of South Carolina

Entry, Junior

Charleston, SC, USA

Category
Risk & Compliance
Legal & Compliance
Requirements
  • High School Degree or Equivalent
  • 1 year of work experience
Responsibilities
  • Responsible for verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to the delivery of inpatient, outpatient, and ancillary services.
  • Determines which patient services have third party payer requirements and is responsible for obtaining the necessary authorizations for care, via phone, fax, or payer websites.
  • Provides detailed and timely communication to both payers and clinical partners in order to facilitate compliance with payer contractual requirements.
  • Responsible for documenting the appropriate information in the patient's record.
  • Other duties as assigned.
Medical University of South Carolina

Medical University of South Carolina

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