Precertification Specialist II - Pre-Access -Days -FT
Precertification Specialist II - Pre-Access -Days -FT
Posted 9 days ago
SENIORITY
Senior
About the role
- Obtains, verifies, and assists in the completion of authorization Monitors a listing of scheduled procedures to begin and complete the authorization process
- Reviews clinical records for supporting documentation and submits to obtain authorization
- Documents accounts and charts with updated authorization statuses based on final payer responses
- Completes authorizations with no more than five incomplete authorizations within a one-year period
- Receives communication from providers and/or the provider's staff when procedures are ordered for outside facilities
- Acts as a liaison with physician offices, insurance companies, and utilization review companies Reports denials and works with providers to appeal as the providers sees fit
- Gathers information requested by providers and assists by prefilling forms
- Communicates with providers regarding incomplete documentation, peer-to-peer review requests, denials and appeals
- Works in conjunction with billing departments to obtain authorizations post service initiation Examines past procedures for performed testing with missing authorizations
- Submits clinical documentation for retroactive or upgraded authorizations
- Collaborates with billing to obtain authorization when denials or audits are necessary due to final payer response
Before you apply
Applying takes about a minute. These four things decide how fast it moves after that.
Your profile is current
It's what we read first. Occupations, seniority and locations matter more than a long history.
Two examples you can talk through
Not a portfolio — just two pieces of work where you can explain the decisions and what you'd change.
A number in mind
What you're on now and what would make you move. We negotiate better when we know both.
Your notice period
Employers plan around it, and it's the question that stalls offers most often.
Once you apply, someone reads it and calls you before anything reaches the employer — usually within two working days.
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