Precertification Specialist
VirtualVocationsPhiladelphia, Pennsylvania, United Statesjob_description.job_card.30_days_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 to handle precertification requests in a call center environment.
Key Responsibilities
Answer incoming calls from members and healthcare professionals regarding precertification requests
Verify member eligibility and provider participation status using multiple database systems
Process precertification requests received via phone, fax, or online portal according to department guidelines
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 ICD10 and CPT codes
General understanding of managed care delivery systems
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Specialist • Philadelphia, Pennsylvania, United States
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