Pre-Certification Manager

Job Summary

Overseeing the entire operation of the Pre-Cert team, the full-time Pre-Certification Manager will manage daily schedules, ensure compliance with payer policies, and focus on process improvements while working remotely.

Key responsibilities

• Oversee daily Pre-Cert operations to ensure timely and accurate eligibility verification, pre-certifications, and patient estimates
• Act as the lead contact with vendor partners to address outstanding cases and prevent disruptions in patient care or revenue loss
• Audit completed cases for compliance and partner with the Accounts Receivable team on denials related to pre-certifications

Required qualifications

• Minimum High School Diploma or GED required
• At least five (5) years of experience in Pre-Certification, Medical Front Office, or Medical Billing
• Experience working remotely is highly preferred
• Proficient knowledge of Medical Terminology, ICD, and CPT Codes
• Ability to effectively manage tasks and meet deadlines while working independently