Behavioral Health Precertification Specialist
VirtualVocationsSanta Ana, California, United Statesjob_description.job_card.variable_hours_ago
serp_jobs.job_preview.job_type
- serp_jobs.job_card.full_time
job_description.job_card.job_description
A company is looking for a Pre-Certification Specialist in Behavioral Health.
Key Responsibilities
Process behavioral health precertification requests in compliance with corporate guidelines and regulations
Verify member eligibility and provider participation status using multiple database systems
Approve selected services and identify requests that require medical necessity reviews
Required Qualifications, Training, and Education
Bachelor's degree preferred, but not required
Previous customer service experience is required
Previous experience in social work or a related field is recommended
Previous medical insurance experience is highly recommended, with behavioral health experience as a plus
Coding knowledge is recommended
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