The Precertification Specialist is responsible for obtaining prior authorizations/pre-certifications, as required by third party payers, for procedures, testing and surgeries performed in the ...
The Precertification Specialist is responsible for obtaining prior authorizations/pre-certifications, as required by third party payers, for procedures, testing and surgeries performed in the ...
The Precertification Specialist is responsible for obtaining prior authorizations/pre-certifications, as required by third party payers, for procedures, testing and surgeries performed in the ...
The Precertification Specialist is responsible for obtaining prior authorizations/pre-certifications, as required by third party payers, for procedures, testing and surgeries performed in the ...
The Precertification Specialist is responsible for obtaining prior authorizations/pre-certifications, as required by third party payers, for procedures, testing and surgeries performed in the ...
The Precertification Specialist is responsible for obtaining prior authorizations/pre-certifications, as required by third party payers, for procedures, testing and surgeries performed in the ...
The Precertification Specialist is responsible for obtaining prior authorizations/pre-certifications, as required by third party payers, for procedures, testing and surgeries performed in the ...
The Precertification Specialist is responsible for obtaining prior authorizations/pre-certifications, as required by third party payers, for procedures, testing and surgeries performed in the ...
Obtains precertification/prior authorizations for in clinic procedures, testing, surgeries, injections, etc., as required by insurance prior to scheduled date for both facility and physician
Obtains precertification/prior authorizations for in clinic procedures, testing, surgeries, injections, etc., as required by insurance prior to scheduled date for both facility and physician
$15 - $18.25/hr
Verify patient information for accurate billing, precertification and patient cost estimations. * Verify eligibility, benefits, patient cost estimates & precertification for scheduled outpatient ...
$15 - $18.25/hr
Verify patient information for accurate billing, precertification and patient cost estimations. * Verify eligibility, benefits, patient cost estimates & precertification for scheduled outpatient ...
Ensures payor precertification has been obtained and communicate to all appropriate parties and placed on the account for billing purposes * Requires extensive phone and computer work * Interacts ...
Ensures payor precertification has been obtained and communicate to all appropriate parties and placed on the account for billing purposes * Requires extensive phone and computer work * Interacts ...
Reimbursement Coordinator
Kansas City, MO · On-site
Ensures payor precertification has been obtained and communicate to all appropriate parties and placed on the account for billing purposes * Requires extensive phone and computer work * Interacts ...
Reimbursement Coordinator
Kansas City, MO · On-site
Ensures payor precertification has been obtained and communicate to all appropriate parties and placed on the account for billing purposes * Requires extensive phone and computer work * Interacts ...
Ensures payor precertification has been obtained and communicate to all appropriate parties and placed on the account for billing purposes * Requires extensive phone and computer work * Interacts ...
Ensures payor precertification has been obtained and communicate to all appropriate parties and placed on the account for billing purposes * Requires extensive phone and computer work * Interacts ...
Ensures payor precertification has been obtained and communicate to all appropriate parties and placed on the account for billing purposes * Requires extensive phone and computer work * Interacts ...
Ensures payor precertification has been obtained and communicate to all appropriate parties and placed on the account for billing purposes * Requires extensive phone and computer work * Interacts ...
Reimbursement Coordinator
Kansas City, MO · On-site
Ensures payor precertification has been obtained and communicate to all appropriate parties and placed on the account for billing purposes * Requires extensive phone and computer work * Interacts ...
Reimbursement Coordinator
Kansas City, MO · On-site
Ensures payor precertification has been obtained and communicate to all appropriate parties and placed on the account for billing purposes * Requires extensive phone and computer work * Interacts ...
Ensures payor precertification has been obtained and communicate to all appropriate parties and placed on the account for billing purposes * Requires extensive phone and computer work * Interacts ...
Ensures payor precertification has been obtained and communicate to all appropriate parties and placed on the account for billing purposes * Requires extensive phone and computer work * Interacts ...
Scheduler - Heart Care Specialists
Saint Louis, MO · On-site
$16.50 - $20.75/hr
Obtains precertification and referrals for procedures. Collects co-pays and balances cash drawer daily. Education, Experience, & Licensing Requirements: Education: High School Diploma or equivalent ...
Scheduler - Heart Care Specialists
Saint Louis, MO · On-site
$16.50 - $20.75/hr
Obtains precertification and referrals for procedures. Collects co-pays and balances cash drawer daily. Education, Experience, & Licensing Requirements: Education: High School Diploma or equivalent ...
Scheduler - Heart Care Specialists
Saint Louis, MO · On-site
$17.50 - $22.75/hr
Obtains precertification and referrals for procedures. Collects co-pays and balances cash drawer daily. Education, Experience, & Licensing Requirements: Education: High School Diploma or equivalent ...
Scheduler - Heart Care Specialists
Saint Louis, MO · On-site
$17.50 - $22.75/hr
Obtains precertification and referrals for procedures. Collects co-pays and balances cash drawer daily. Education, Experience, & Licensing Requirements: Education: High School Diploma or equivalent ...
Scheduler - Heart Care Specialists
Saint Louis, MO · On-site
$16 - $20/hr
Obtains precertification and referrals for procedures. Collects co-pays and balances cash drawer daily. Education, Experience, & Licensing Requirements: Education: High School Diploma or equivalent ...
Scheduler - Heart Care Specialists
Saint Louis, MO · On-site
$16 - $20/hr
Obtains precertification and referrals for procedures. Collects co-pays and balances cash drawer daily. Education, Experience, & Licensing Requirements: Education: High School Diploma or equivalent ...
Scheduler - Heart Care Specialists
Saint Louis, MO · On-site
$16 - $20/hr
Obtains precertification and referrals for procedures. Collects co-pays and balances cash drawer daily. Education, Experience, & Licensing Requirements: Education: High School Diploma or equivalent ...
Scheduler - Heart Care Specialists
Saint Louis, MO · On-site
$16 - $20/hr
Obtains precertification and referrals for procedures. Collects co-pays and balances cash drawer daily. Education, Experience, & Licensing Requirements: Education: High School Diploma or equivalent ...
Patient Access Clerk
$14.75 - $19.75/hr
Coordinates determination of eligibility and benefits and ensures insurance precertification, referral, and authorization requirements have been met for all payers. * Completes all necessary ...
Patient Access Clerk
$14.75 - $19.75/hr
Coordinates determination of eligibility and benefits and ensures insurance precertification, referral, and authorization requirements have been met for all payers. * Completes all necessary ...
Patient Access Clerk
Richmond, MO · On-site
$14.75 - $19.75/hr
Coordinates determination of eligibility and benefits and ensures insurance precertification, referral, and authorization requirements have been met for all payers. * Completes all necessary ...
Quick apply
Patient Access Clerk
Richmond, MO · On-site
$14.75 - $19.75/hr
Coordinates determination of eligibility and benefits and ensures insurance precertification, referral, and authorization requirements have been met for all payers. * Completes all necessary ...
Patient Access Clerk
Richmond, MO · On-site
$14.75 - $19.75/hr
Coordinates determination of eligibility and benefits and ensures insurance precertification, referral, and authorization requirements have been met for all payers. * Completes all necessary ...
Patient Access Clerk
Richmond, MO · On-site
$14.75 - $19.75/hr
Coordinates determination of eligibility and benefits and ensures insurance precertification, referral, and authorization requirements have been met for all payers. * Completes all necessary ...
Precertification information
What is a precertification specialist?
Precertification jobs involve reviewing and approving medical procedures, treatments, or hospital admissions before they occur to ensure they meet insurance or regulatory requirements. Professionals in these roles typically evaluate patient information, communicate with healthcare providers, and coordinate with insurance companies to determine if services will be covered. This process helps control healthcare costs and ensures that patients receive appropriate care according to established guidelines. Precertification specialists often work in hospitals, insurance companies, or healthcare administration settings.
What skills and qualifications are needed to thrive as a precertification specialist?
Success as a precertification specialist requires knowledge of medical terminology, insurance verification, and healthcare regulations, often supported by a background in healthcare administration or certification such as Certified Medical Administrative Assistant (CMAA). Familiarity with insurance portals, electronic health record (EHR) systems, and payer-specific software is typically necessary. Attention to detail, strong organizational skills, and effective communication are vital soft skills that help in coordinating between providers, patients, and insurers. These abilities ensure accurate and timely approval of medical procedures, reducing delays in patient care and minimizing claim denials.
What are common challenges faced by precertification specialists, and how can they be addressed?
Precertification Specialists often face challenges such as staying up-to-date with constantly changing insurance guidelines, managing high volumes of requests, and communicating effectively with both healthcare providers and insurance representatives. To address these, it is important to maintain strong organizational skills, leverage available technology for tracking authorizations, and participate in ongoing training to remain current on payer requirements. Building good relationships with team members and regularly sharing updates can also help streamline processes and minimize delays.
What is the difference between Precertification vs Medical Coder?
| Aspect | Precertification | Medical Coder |
|---|---|---|
| Required credentials | Certification may be preferred; knowledge of insurance policies | Certification (e.g., CPC, CCS) often required |
| Work environment | Healthcare facilities, insurance companies, outpatient clinics | Hospitals, clinics, insurance companies, remote work |
| Employer usage | Used to approve procedures before service | Used to assign codes for billing and documentation |
| Common search intent | Precertification vs Medical Coder |
Precertification involves obtaining approval from insurance companies before procedures, focusing on insurance policies and patient eligibility. Medical coders assign standardized codes to medical records for billing, emphasizing coding accuracy and documentation. While both roles are integral to healthcare billing, precertification is about approval processes, whereas medical coding centers on documentation and coding accuracy.
What are the most commonly searched types of Precertification jobs in Missouri?
The most popular types of Precertification jobs in Missouri are:
What are popular job titles related to Precertification jobs in Missouri?
For Precertification jobs in Missouri, the most frequently searched job titles are:
- Part Time Medical Biller
- Laboratory Billing
- Remote Electronic Health Records Specialist
- Clinical Appeals Specialist
- Precertification Specialist
- Remote Denial Analyst
- Work From Home Medicaid Billing Specialist
- Medical Reimbursement Specialist
- No Experience Medical Billing Coding Willing To Train
- Medical Billing Specialist
What job categories do people searching Precertification jobs in Missouri look for?
The top searched job categories for Precertification jobs in Missouri are:
- Night Shift Remote Medical Billing
- Work From Home Medical Billing Charge Entry
- Keybridge Medical Revenue Care
- Remote Medical Billing Accounts Receivable
- Remote Claim Processor
- Contract Remote Orthopedic
- Digestive Care Specialists
- Remote Rare Disease Specialist
- Overnight Research Billing Specialist
- Medical Billing Director
Full-time
Posted 26 days ago
Saint Luke's Health System (Kansas City) rating
7.1
Based on 110 frontline employees who took The Breakroom Quiz
382nd of 893 rated healthcare providers
Job description
Job Description
The Precertification Specialist is responsible for obtaining prior authorizations/pre-certifications, as required by third party payers, for procedures, testing and surgeries performed in the department or elsewhere. The position regularly interacts and collaborates with clinicians, technicians, other department staff and payer representatives to gather and submit necessary information, and then communicates with patients regarding their benefits and expected out-of-pocket costs.
Job Requirements
Applicable Experience:
1 year
Job Details
Full Time
Day (United States of America)
The Precertification Specialist is responsible for obtaining prior authorizations/pre-certifications, as required by third party payers, for procedures, testing and surgeries performed in the department or elsewhere. The position regularly interacts and collaborates with clinicians, technicians, other department staff and payer representatives to gather and submit necessary information, and then communicates with patients regarding their benefits and expected out-of-pocket costs.
- Obtains precertification/prior authorizations for in clinic procedures, testing, surgeries, injections, etc., as required by insurance prior to scheduled date for both facility and physician
- Coordinates with physician to ensure that patient's condition meets insurance eligibility criteria
- Updates appropriate work queues within Epic, including notes with updates on calls made, departments/people spoke with, prior auth numbers and authorization periods
- Interacts with the Financial Clearance Center Team to coordinate information needed to communicate benefits and patient responsibility for the facility billing portion
- Runs report on Experian to obtain the physician billing estimate and interacts with the Physician CBO to coordinate information needed to communicate benefits and patient responsibility for the physician billing portion
- Communicates regularly with patient to update on prior authorization and to provide patient responsibility estimate for both facility and physician billing sides.
- Interacts with OR and/or ASC staff to obtain scheduling information and to coordinate communication to the patient
- Schedules procedure with vendor rep, as needed
Job Requirements
Applicable Experience:
1 year
Job Details
Full Time
Day (United States of America)
What Saint Luke's Health System (Kansas City) employees say
Pay
Benefits
Hours and flexibility
Workplace
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About Saint Luke's
Sourced by ZipRecruiter
Industry
Hospitals
Company size
10,000+ Employees
Headquarters location
Kansas City, MO, US
Year founded
1882