Pre-Certification Specialist
Job in
Providence, Providence County, Rhode Island, 02912, USA
Listed on 2026-01-27
Listing for:
Prospect Medical Holdings, Inc.
Full Time
position Listed on 2026-01-27
Job specializations:
-
Healthcare
Healthcare Administration, Medical Billing and Coding
Job Description & How to Apply Below
Summary
Responsible to obtain all required authorizations prior to treatments being performed in the Cancer Center/Infusion Suites, including verification of patient insurance coverage, benefit levels and out of pocket responsibilities. Responsible to obtain, enter, and track all authorizations and pre-certs as required by the individual insurance company. The specialist will be familiar with and understand Medicare, Medicaid, other government payers, Commercial and HMO/PPO Payers guidelines and principals.
Qualifications- Education:
High school graduate or GED required. Associate's level degree preferred. - Experience:
Prior experience working in a related role in a medical office or other health care related organization. 2-3 years of prior insurance verification and preauthorization work or related experience in a health care environment.
- Entry level
- Full-time
- Information Technology
- Hospitals and Health Care
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