Pre-Certification Representative

Job Summary

To support healthcare operations, the remote Pre-Certification Representative will manage pre-certification requests from insurance companies, ensuring accurate data input and effective communication with healthcare providers and patients.

Key responsibilities

• Obtain pre-certification for services by effectively communicating with insurance companies and placing calls to health plans
• Accurately enter and update patient data, verifying medical insurance information and handling claim denials
• Maintain confidentiality and adhere to HIPAA standards while managing patient intake and insurance verification processes

Required qualifications

• High School diploma or equivalent required
• Minimum of 2-3 years of experience in healthcare or physician's office related to pre-authorizations
• Extensive knowledge of individual payor websites and medical terminology, including CPT and diagnosis codes
• Experience with GE Centricity or EPIC PB preferred
• Proficiency in Microsoft Office Suite and strong organizational skills