Precertification Representative - Remote in EST
About the position 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 Microsoft Word, Microsoft Excel, and Microsoft 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 Nice-to-haves • Experience working within 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 Apply tot his job