Georgia Licensed Precertification Specialist

Job Summary

To enhance patient access to services, the full-time Georgia Licensed Precertification Specialist will obtain pre-certification for outpatient diagnostic procedures and referrals while providing exceptional customer service in a remote environment.

Key responsibilities:

• Obtain pre-authorization for outpatient testing and medications, ensuring timely completion within a three-day lead time
• Act as a liaison between physicians, nurses, and insurance carriers to resolve authorization issues and communicate concerns effectively
• Maintain accurate records and documentation, ensuring compliance with payer policies and minimizing authorization denials

Required qualifications:

• High School Diploma or GED; Associate's degree preferred
• Minimum of 1 year experience in customer service or healthcare setting
• Experience with computer data entry and knowledge of insurance benefits preferred
• Understanding of outpatient procedures and pre-authorization requirements
• Ability to communicate effectively with healthcare team members and manage multiple tasks in a fast-paced environment