Patient Access Precertification Specialist

Job Summary

To ensure a positive patient/provider experience, the full-time Patient Access Precertification Specialist will verify eligibility, complete pre-authorizations, and maintain communication with insurance companies while primarily working remotely with occasional onsite obligations.

Key responsibilities

• Verifies eligibility and manages pre-authorizations for scheduled procedures, ensuring compliance with departmental requirements
• Maintains ongoing communication with insurance companies and responds to inquiries from providers and patients regarding authorizations
• Enters and monitors relevant data in IDX and SMS/Invision systems to ensure accurate billing and authorization statuses

Required qualifications

• High School Diploma or GED required
• 1-2 years of experience in patient accounting, patient access, or pre-arrival services functions
• Basic knowledge of UB04, HCFA 1500 forms, and payer authorization processes
• Familiarity with medical terminology and CPT/ICD-10 coding
• Proficiency in hospital registration/billing systems and Microsoft Office applications