Preauthorization/Precertification Specialist

Benefits:

• 401(k)
• 401(k) matching
• Free food & snacks
• Paid time off

About the Role:
Join East Tennessee Gastroenterology PLL as a Preauthorization/Precertification Specialist, where you will play a vital role in ensuring smooth patient care processes. This position is perfect for detail-oriented professionals who thrive in a fast-paced environment and are passionate about supporting healthcare services in the Cleveland, TN area.

Responsibilities:

• Review and process preauthorization and precertification requests for medical procedures and services.
• Communicate effectively with insurance companies, healthcare providers, and patients regarding authorization status.
• Maintain accurate records of all preauthorization activities and outcomes in the electronic health record system.
• Collaborate with clinical staff to gather necessary documentation for authorization submissions.
• Monitor pending authorizations and follow up as needed to ensure timely approvals.
• Stay updated on insurance policies and changes to ensure compliance and accuracy.
• Assist in resolving any authorization-related issues or denials with appropriate follow-up actions.
• Provide exceptional customer service to patients and healthcare providers throughout the authorization process.

Requirements:

• High school diploma or equivalent; relevant certification in medical billing or coding is a plus.
• Minimum of 2 years of experience in healthcare insurance verification or preauthorization roles.
• Strong knowledge of medical terminology and coding (CPT, ICD-10).
• Excellent communication skills, both verbal and written, with a customer-focused approach.
• Proficient in using electronic health record systems and Microsoft Office Suite.
• Detail-oriented with strong organizational and time management skills.
• Ability to work independently and as part of a team in a fast-paced environment.
• Demonstrated ability to handle sensitive information with confidentiality and professionalism.

About Us:
East Tennessee Gastroenterology PLL has been serving the Cleveland, TN community for over a decade, providing top-notch gastrointestinal care. Our dedicated team is known for their compassionate approach and commitment to patient satisfaction, making us a trusted choice for both patients and employees alike.