Precertification Representative

A company is looking for a Precertification and Authorization Representative-Remote.

Key Responsibilities

Resolve referral, precertification, and prior authorization for various payors in hospital and clinic settings

Process pre-certification and prior authorization for workers compensation and managed care accounts

Adhere to quality assurance guidelines and productivity standards within the Patient Access department

Required Qualifications

High School Diploma or GED with 2+ years of relevant experience, or a Bachelor's degree

General knowledge of healthcare terminology and CPT-ICD10 codes

Basic knowledge of insurance verification and claim adjudication preferred

Experience with Epic RC / EMR system preferred

Healthcare Financial Management Association (HFMA) Certification preferred