Pre-Certification Specialist II

Job Summary

A company is looking for a Pre-Certification Specialist II (Therapy Services).

Key Responsibilities

• Verify benefits and obtain insurance authorizations for therapy services
• Ensure timely management of referrals and pre-certifications prior to patient services
• Document and communicate denied requests to appropriate areas and maintain accurate records in the Epic system

Required Qualifications

• High School Diploma required
• Minimum of 1 year of relevant experience in a healthcare environment; 3+ years preferred
• Experience in medical insurance precertification and knowledge of Florida Medicaid preferred
• Familiarity with CPT, ICD-10 codes, and medical terminology preferred
• Basic knowledge of Microsoft Word and Excel required