Pre-Certification Coordinator

Job Summary

Managing complex pre-certifications for specialized services, the full-time remote Pre-Certification Coordinator will verify insurance eligibility, document authorization information in EPIC, and collaborate with clinical staff to resolve issues related to pre-certifications.

Key responsibilities:

• Complete pre-certifications for complex services based on therapy and treatment plans, ensuring accurate documentation in EPIC
• Perform re-checks on existing pre-certifications by verifying insurance eligibility and authorization information
• Collaborate with clinical staff and providers on add-ons, denials, and peer-to-peer communications to achieve timely resolutions

Required qualifications:

• High school diploma or equivalent certification
• Minimum of 3 years of experience in Clinical Office, Medical Billing, Health Information Management, or Pre-Certification
• Experience with insurance pre-certification processes and terminology
• Proficiency in using EPIC for documentation and communication
• No specific certification or professional license required