Pre-Certification Coordinator

Job Summary

To support the orthopedic surgery department, the full-time remote Pre-Certification Coordinator will manage complex pre-certifications, verify insurance eligibility, and communicate effectively with clinical staff and providers.

Key responsibilities:

• Completes pre-certifications for complex services based on therapy and treatment plans, ensuring all documentation is processed in EPIC
• Verifies insurance eligibility and authorization information for existing pre-certifications, documenting all findings in EPIC
• Collaborates with clinical staff and providers to resolve issues related to add-ons, denials, and peer-to-peer reviews

Required qualifications:

• High school diploma or equivalent certification, or a combination of education and experience
• Minimum of 3 years of experience in a clinical office, medical billing, health information management, or pre-certification
• Experience with EPIC or similar electronic health record systems is preferred
• Associate degree is preferred but not required
• No specific certification or professional license required for this position