Behavioral Health Precertification Specialist

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