Pre-Certification Coordinator

Pay: Competitive, DOE
Schedule: Full-Time
Job Type: Non-Exempt

Pre-Certification Coordinator Position Overview

We are seeking a detail-oriented Pre-Certification Coordinator to join a busy specialty medical clinic. This individual will play a key role in verifying insurance coverage, obtaining prior authorizations, communicating patient financial responsibility, and coordinating services to ensure patients are approved before their appointments.

The ideal candidate has experience working with medical insurance, enjoys helping patients, and thrives in a fast-paced healthcare environment.

Pre-Certification Coordinator Qualifications

• 1+ years of experience in medical insurance verification, prior authorizations, medical billing, or a related healthcare administrative role preferred
• Experience with commercial insurance, Medicare, Medicaid, and third-party payers
• Knowledge of referrals, prior authorizations, and insurance eligibility verification
• Experience working with an Electronic Health Record (EHR) system
• Strong customer service, communication, and organizational skills
• Excellent attention to detail and problem-solving abilities
• Proficient in Microsoft Office (Outlook, Word, Excel)
• Associate's or Bachelor's degree in Healthcare Administration, Business, Finance, or a related field is a plus

Pre-Certification Coordinator Responsibilities

• Verify patient insurance eligibility and benefits
• Obtain required referrals, prior authorizations, and pre-certifications
• Review insurance coverage and calculate patient financial responsibility
• Communicate payment expectations with patients prior to services
• Coordinate authorizations for ancillary services, including radiology, pain management, neurology, and other specialty services
• Schedule appointments as needed
• Review patient accounts to ensure accurate fee collection
• Answer incoming calls and return patient messages promptly
• Complete assigned tasks within the Electronic Health Record (EHR)
• Collaborate with providers and clinic staff to ensure approvals are completed before appointments
• Maintain HIPAA compliance and protect patient confidentiality
• Deliver exceptional customer service while supporting patients throughout the authorization process

Pre-Certification Coordinator Knowledge & Skills

• Understanding of commercial insurance plans, Medicare, Medicaid, and payer guidelines
• Knowledge of medical referrals, authorizations, and benefits verification
• Strong analytical, organizational, and multitasking skills
• Ability to work independently and as part of a team
• Ability to type approximately 50 WPM

Pre-Certification Coordinator Physical Requirements

• Ability to sit and work at a computer for extended periods
• Frequent use of standard office equipment
• Ability to stand, walk, bend, and move throughout the clinic as needed
• Ability to lift up to 50 pounds occasionally
• Ability to work efficiently in a fast-paced clinical environment

Schedule

• Monday – Thursday: 8:00 AM – 5:00 PM
• Friday: 8:00 AM – 1:00 PM

Hours may vary based on clinic needs.

Why Join Us?

• Monday through Friday schedule with early Fridays
• Supportive and collaborative team environment
• Opportunity to make a meaningful impact on patient care
• Competitive pay based on experience
• Long-term career opportunity with a growing specialty medical practice

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