About the Role
The Pre-Certification Coordinator II is responsible for obtaining insurance pre-authorizations for medical services, ensuring timely and accurate documentation, and serving as a liaison between providers and insurance companies to facilitate patient access to care.
Responsibilities
- Obtain pre-certification and authorization approvals for medical procedures and services
- Verify patient insurance eligibility and benefits prior to scheduled care
- Communicate with healthcare providers to gather clinical information needed for authorizations
- Interact with insurance companies to resolve coverage questions and delays
- Maintain accurate records of authorization status and correspondence
- Ensure compliance with payer-specific requirements and regulatory standards
- Track pending authorizations and follow up to prevent service delays
- Escalate complex cases to supervisors or case management when necessary
- Support timely patient scheduling by coordinating authorization timelines
- Identify and report recurring insurance-related issues to management
- Utilize electronic health and billing systems to document and update authorization records
- Adhere to patient confidentiality and HIPAA guidelines in all communications
- Assist in training new staff on pre-certification workflows and tools
- Participate in departmental quality improvement initiatives
- Respond to internal inquiries regarding pre-authorization status and requirements
Compensation
Salary commensurate with experience
Work Arrangement
Remote
Team
Part of the Department of Medicine administrative team
Application Process
Applicants must submit a resume and complete the online application to be considered. Incomplete applications will not be reviewed. The hiring team may contact shortlisted candidates for interviews.
Equal Opportunity Employer
The organization is committed to diversity and inclusion in the workplace and does not discriminate on the basis of race, color, religion, sex, national origin, disability, age, or other protected status.
Not available
