We are hiring a supervisor for the surgery scheduling and precertification team. You will provide quality control and improvement for workflows within the surgery scheduling and precertification ...
We are hiring a supervisor for the surgery scheduling and precertification team. You will provide quality control and improvement for workflows within the surgery scheduling and precertification ...
We are hiring a supervisor for the surgery scheduling and precertification team. You will provide quality control and improvement for workflows within the surgery scheduling and precertification ...
We are hiring a supervisor for the surgery scheduling and precertification team. You will provide quality control and improvement for workflows within the surgery scheduling and precertification ...
We are hiring a supervisor for the surgery scheduling and precertification team. You will provide quality control and improvement for workflows within the surgery scheduling and precertification ...
We are hiring a supervisor for the surgery scheduling and precertification team. You will provide quality control and improvement for workflows within the surgery scheduling and precertification ...
Job Summary and Qualifications The Precertification Representative is responsible for requesting, obtaining and following up on authorization requests. Requests and interdepartmental scheduling with ...
Job Summary and Qualifications The Precertification Representative is responsible for requesting, obtaining and following up on authorization requests. Requests and interdepartmental scheduling with ...
Knowledge of Insurance - particularly coordination of benefit rules and precertification denial overturns are essential to this position. * Strong organizational and interpersonal skills
Knowledge of Insurance - particularly coordination of benefit rules and precertification denial overturns are essential to this position. * Strong organizational and interpersonal skills
Knowledge of Insurance - particularly coordination of benefit rules and precertification denial overturns are essential to this position. * Strong organizational and interpersonal skills
Knowledge of Insurance - particularly coordination of benefit rules and precertification denial overturns are essential to this position. * Strong organizational and interpersonal skills
Knowledge of Insurance - particularly coordination of benefit rules and precertification denial overturns are essential to this position. * Strong organizational and interpersonal skills
Knowledge of Insurance - particularly coordination of benefit rules and precertification denial overturns are essential to this position. * Strong organizational and interpersonal skills
Knowledge of Insurance - particularly coordination of benefit rules and precertification denial overturns are essential to this position. * Strong organizational and interpersonal skills
Knowledge of Insurance - particularly coordination of benefit rules and precertification denial overturns are essential to this position. * Strong organizational and interpersonal skills
RN-Order/Medical Review
Memphis, TN · On-site
Job Summary Coordinates precertification/authorization services for patients across the continuum of care, promoting quality care, and effective utilization of resources. Provides leadership when ...
RN-Order/Medical Review
Memphis, TN · On-site
Job Summary Coordinates precertification/authorization services for patients across the continuum of care, promoting quality care, and effective utilization of resources. Provides leadership when ...
RN-Order/Medical Review
Memphis, TN · On-site
Overview Job Summary Coordinates precertification/authorization services for patients across the continuum of care, promoting quality care, and effective utilization of resources. Provides leadership ...
RN-Order/Medical Review
Memphis, TN · On-site
Overview Job Summary Coordinates precertification/authorization services for patients across the continuum of care, promoting quality care, and effective utilization of resources. Provides leadership ...
RN-Order/Medical Review
Collierville, TN · On-site
* Department Centralized Patient Access Center Job Summary Coordinates precertification/authorization services for patients across the continuum of care, promoting quality care, and effective ...
RN-Order/Medical Review
Collierville, TN · On-site
* Department Centralized Patient Access Center Job Summary Coordinates precertification/authorization services for patients across the continuum of care, promoting quality care, and effective ...
RN-Order/Medical Review
Memphis, TN · On-site
Overview Job Summary Coordinates precertification/authorization services for patients across the continuum of care, promoting quality care, and effective utilization of resources. Provides leadership ...
RN-Order/Medical Review
Memphis, TN · On-site
Overview Job Summary Coordinates precertification/authorization services for patients across the continuum of care, promoting quality care, and effective utilization of resources. Provides leadership ...
RN-Order/Medical Review
Memphis, TN · On-site
Job Summary Coordinates precertification/authorization services for patients across the continuum of care, promoting quality care, and effective utilization of resources. Provides leadership when ...
RN-Order/Medical Review
Memphis, TN · On-site
Job Summary Coordinates precertification/authorization services for patients across the continuum of care, promoting quality care, and effective utilization of resources. Provides leadership when ...
Specialty Pharmacy Prior Authorization Specialist Medical Authorizations
$17.50 - $23.25/hr
Responsible for precertification of eligible prescriptions. Ensures complete documentation is obtained that meets insurer guidelines for medical necessity and payment for services. Models appropriate ...
Specialty Pharmacy Prior Authorization Specialist Medical Authorizations
$17.50 - $23.25/hr
Responsible for precertification of eligible prescriptions. Ensures complete documentation is obtained that meets insurer guidelines for medical necessity and payment for services. Models appropriate ...
Pharmacy Mail Order Prior Authorization Specialist (PTCB Required)
Memphis, TN · On-site
$17 - $20.75/hr
Responsible for precertification of eligible prescriptions. Ensures complete documentation is obtained that meets insurer guidelines for medical necessity and payment for services. Models appropriate ...
Pharmacy Mail Order Prior Authorization Specialist (PTCB Required)
Memphis, TN · On-site
$17 - $20.75/hr
Responsible for precertification of eligible prescriptions. Ensures complete documentation is obtained that meets insurer guidelines for medical necessity and payment for services. Models appropriate ...
Pharmacy Prior Authorization Specialist- - FT(Days)
Memphis, TN · On-site
$20 - $25.75/hr
Responsible for precertification of eligible prescriptions. Ensures complete documentation is obtained that meets insurer guidelines for medical necessity and payment for services. Models appropriate ...
Pharmacy Prior Authorization Specialist- - FT(Days)
Memphis, TN · On-site
$20 - $25.75/hr
Responsible for precertification of eligible prescriptions. Ensures complete documentation is obtained that meets insurer guidelines for medical necessity and payment for services. Models appropriate ...
Responsible for precertification of eligible prescriptions. Ensures complete documentation is obtained that meets insurer guidelines for medical necessity and payment for services. Models appropriate ...
Responsible for precertification of eligible prescriptions. Ensures complete documentation is obtained that meets insurer guidelines for medical necessity and payment for services. Models appropriate ...
Specialty Pharmacy Prior Authorization Specialist
$20 - $25.75/hr
Responsible for precertification of eligible prescriptions. Ensures complete documentation is obtained that meets insurer guidelines for medical necessity and payment for services. Models appropriate ...
Specialty Pharmacy Prior Authorization Specialist
$20 - $25.75/hr
Responsible for precertification of eligible prescriptions. Ensures complete documentation is obtained that meets insurer guidelines for medical necessity and payment for services. Models appropriate ...
Pharmacy Authorization Specialist | FT | Days | University
Memphis, TN · On-site
$18.25 - $23.75/hr
Responsible for precertification of eligible prescriptions. Ensures complete documentation is obtained that meets insurer guidelines for medical necessity and payment for services. Models appropriate ...
Pharmacy Authorization Specialist | FT | Days | University
Memphis, TN · On-site
$18.25 - $23.75/hr
Responsible for precertification of eligible prescriptions. Ensures complete documentation is obtained that meets insurer guidelines for medical necessity and payment for services. Models appropriate ...
PA technician specialist
Memphis, TN · On-site
$17 - $20.75/hr
Responsible for precertification of eligible prescriptions. Ensures complete documentation is obtained that meets insurer guidelines for medical necessity and payment for services. Models appropriate ...
PA technician specialist
Memphis, TN · On-site
$17 - $20.75/hr
Responsible for precertification of eligible prescriptions. Ensures complete documentation is obtained that meets insurer guidelines for medical necessity and payment for services. Models appropriate ...
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 Tennessee?
The most popular types of Precertification jobs in Tennessee are:
What are popular job titles related to Precertification jobs in Tennessee?
For Precertification jobs in Tennessee, the most frequently searched job titles are:
What job categories do people searching Precertification jobs in Tennessee look for?
The top searched job categories for Precertification jobs in Tennessee are:
Scheduling & Precertification Supervisor
Memphis, TN • On-site
Semmes Murphey Clinic
• Outpatient Health Care • 201 - 500 employees201 - 500 employees
Full-time
Posted 10 days ago
Job description
Description
Semmes Murphey Clinic's mission is to deliver the best care for people suffering from neurological illness while advancing the field of neuroscience.
We are hiring a supervisor for the surgery scheduling and precertification team. You will provide quality control and improvement for workflows within the surgery scheduling and precertification process. This role is an important partner and resource for various departments including the clinic, ambulatory surgery center, radiology, and call center. You are also an important resource for the physicians and their staff. You will also address and resolve escalated patient complaints.
Requirements
Minimum
- High School Diploma or equivalent
- Five (5) years experience in a medical practice/hospital
Preferred
- Associate's or bachelor's degree in Healthcare Management/Administration or related field
- Prior Supervisory experience
- Experience working in a clinic setting
Knowledge, Skills, and Abilities
- Proficient in Microsoft Office (Excel, Outlook and Word), electronic medicals records (EMR) and medical practice software
- Proficient with standard terminology, concepts, practices and procedures within the medical/insurance field
- Can identify ways to streamline processes and improve efficiency without sacrificing quality and accuracy
- Effective communication, both oral and written, with the ability to speak clearly and persuasively in positive and negative situations while listening and responding appropriately to questions
- Can provide excellent customer service while managing difficult or emotional situations
- Excellent interpersonal skills with the ability to tactfully interact with all levels of the organization
Equal Opportunity Employer/Veterans/Disabled
#SMC
About Semmes Murphey Clinic
Sourced by ZipRecruiter
Industry
Outpatient health care
Company size
201 - 500 Employees
Headquarters location
Memphis, TN, US
Year founded
1912