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Precertification/Authorization Specialist

MUSC

Responsible for verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to the delivery of inpatient, outpatient, and ancillary services. This individual determines which patient services require third party payer authorizations and is responsible for obtaining the necessary approvals for care via phone, fax, or payer websites. The Specialist provides detailed and timely communication to payers and clinical partners to facilitate compliance with payer contractual requirements and documents the appropriate information in the patient's record.

Other duties as assigned.

Education: High School Degree or Equivalent

Work Experience: 1 year

Join a dynamic team at the Medical University of South Carolina, dedicated to patient care and excellence in healthcare.

Requirements & Qualifications
  • High School Degree or equivalent
  • Minimum 1 year work experience in a related role
  • Knowledge of insurance eligibility and authorization processes
  • Ability to communicate effectively with payers and clinical partners
  • Detail-oriented with strong documentation skills
Benefits & Perks
  • Employment at a leading academic health system
  • Opportunities for career growth and development
  • Inclusive and equal opportunity employer environment
  • Participation in federal E-Verify program

Location

South Carolina, US

Employment Type

Full-time

Experience Level

Entry Level

Remote work allowed

No

Posted

2 weeks ago

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