Precertification and Authorization Rep- Remote

About the position Responsibilities • Resolve referral, precertification, and prior authorization issues for various payors. • Support insurance specific plan requirements across hospital, ED, and clinic environments. • Process pre-certification and prior authorization for workers compensation and managed care accounts. • Handle assigned registration denials for government and non-government accounts. • Conduct pre-appointment insurance reviews (PAIR) and denial recovery functions. • Adhere to quality assurance guidelines and established productivity standards. Requirements • High School Diploma or GED and 2+ years of relevant experience required OR Bachelor's degree required. • Ability to read and communicate effectively. • Basic computer/keyboarding skills and intermediate mathematic competency. • Good written and verbal communication skills. • Knowledge of proper phone etiquette and phone handling skills. • General knowledge of healthcare terminology and CPT-ICD10 codes. • Basic knowledge of insurance verification and claim adjudication preferred. • Excellent verbal communication skills and ability to work in a complex environment. • Comfortable with ambiguity and exhibit good decision making and judgment capabilities. • Attention to detail and knowledge of denial codes preferred. • Experience using an Epic RC/EMR system preferred. Nice-to-haves • Knowledge of denial codes. • Experience using an Epic RC/EMR system. Benefits • Competitive compensation • Comprehensive benefit plans • Continuing education and advancement opportunities • Remote work options • Support for diversity, equity, and inclusion initiatives Apply tot his job Apply To this Job