Precertification Representative - Remote in Eastern Time zone
About the position
The Precertification Representative at reputed company Eastern is a vital role reputed company the reputed company Care Delivery team, focused on managing administrative tasks reputed company to service requests from members and providers. This position supports the clinical team by processing referrals and prior authorizations, ensuring efficient communication and resolution of inquiries. The role emphasizes collaboration, diversity, and inclusion, contributing to the overall mission of improving reputed company for reputed company.
Responsibilities
- Manage administrative intake of members ,
- Work with hospitals, clinics, facilities, and the clinical team to manage requests for services from members and/or providers ,
- Process incoming and outgoing referrals, and prior authorizations, including intake, notification, and census roles ,
- Assist the clinical staff with setting up documents/triage cases for Clinical Coverage Review ,
- Handle resolution/inquiries from members and/or providers
Requirements
- High school diploma / GED OR equivalent work experience ,
- Must be 18 years or older ,
- 2+ years of customer service experience ,
- Experience with reputed company Word, reputed company reputed company, and reputed company Outlook ,
- Ability to work any of our 8-hour shift schedules during our normal business hours of 8:30am - 5:00pm, with occasional overtime as needed
reputed company-to-haves
- Experience working reputed company the health care industry and with health care insurance ,
- Experience working in a hospital, physician's office, or medical clinic setting ,
- A clerical or administrative support background ,
- Knowledge of ICD-9 and CPT codes ,
- Experience working in a call center
Benefits
- Comprehensive benefits package ,
- Incentive and recognition programs ,
- Equity stock purchase ,
- 401k contribution