Pre-Certification Coordinator

Job Summary

To support the Department of Medicine, the full-time remote Pre-Certification Coordinator will manage complex pre-certifications, verify insurance eligibility, and collaborate with clinical staff to resolve authorization issues efficiently.

Key responsibilities:

• Completes pre-certifications for specialized services by analyzing therapy and treatment plans and payer policies
• Verifies insurance eligibility and authorization information for existing pre-certifications, documenting all updates in EPIC
• Works with clinical staff on add-ons, denials, and peer-to-peer communications to ensure timely resolutions

Required qualifications:

• High school diploma or equivalent certification, or a combination of education and experience
• Three years of work experience in Clinical Office, Medical Billing, Health Information Management, or Pre-Certification
• Associate degree is preferred
• Experience with EPIC or similar healthcare documentation systems is advantageous
• No specific certification or professional license is required for this position