Pre-Certification Specialist
Job Summary
Processing precertification requests in a fully remote capacity, the Pre-Certification Specialist will handle high-volume calls from members and healthcare professionals, verify eligibility, and ensure compliance with corporate guidelines and regulations.
Key responsibilities:
- Manage incoming calls regarding precertification requests from members and healthcare professionals
- Verify member eligibility and provider participation status using multiple database systems
- Process precertification requests and enter pertinent data into the appropriate systems
Required qualifications:
- High school diploma required; associate degree in a related field preferred
- Minimum of three years of customer service experience in the health insurance or health services industry
- Knowledge of medical terminology and familiarity with ICD9/ICD10 and CPT codes
- Experience with computerized databases, including Word, Excel, and Mainframe
- Knowledge of INSINQ is a plus
Complete Job Description
The complete job description is available to members. Premium membership includes:
Full access to 47,805 remote jobs from human-vetted companies, updated daily
Resume Builder - AI-powered tool to craft, enhance, and tailor your resume to a specific job
Twice-monthly live group coaching and the full Remote Career Center
20% member discount on Career Services
Backed by a 30-day money-back guarantee
Company Company Name
Headquarters Headquarters
Founded Founded
Website
Wikipedia Wikipedia URL
BBB URL BBB URL
The company description is available to members. Go Premium for full access to every job and company profile in our remote jobs database, backed by a 30-day money-back guarantee.
