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Pre-Certification Coordinator
Job Summary
A company is looking for a Pre-Certification Coordinator specializing in complex pre-certifications for high dollar oncology and non-oncology drugs.
Key Responsibilities
- Complete pre-certifications for complex and high dollar drugs based on therapy and treatment plans
- Verify insurance eligibility and authorization information for existing pre-certifications
- Collaborate with clinical staff and providers on add-ons, denials, and peer-to-peer resolutions
Required Qualifications
- High school diploma or equivalent certification
- 3 years of experience in Clinical Office, Medical Billing, Health Information Management, or Pre-Certification
- No specific certification required
- Experience with insurance terminology and managed care plans preferred
- Associate degree and/or relevant certifications (CPC or RHIT) preferred
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COMPLETE JOB DESCRIPTION
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