Pre-Certification Coordinator

Job Summary

A company is looking for a Pre-Certification Coordinator II (Remote).

Key Responsibilities

• Completes pre-certifications for complex and high dollar drugs based on therapy and treatment plans
• Performs rechecks on existing pre-certifications by verifying insurance eligibility and authorization information
• Collaborates with clinical staff and providers to resolve add-ons, denials, and peer-to-peer issues

Required Qualifications

• High school diploma or equivalent certification or combination of education and/or experience
• Minimum of 3 years of experience in Clinical Office, Medical Billing, Health Information Management, or Pre-Certification
• No specific certification required
• Experience with insurance databases and terminology is preferred
• Associate degree is preferred