Precertification Specialist

The Pulmonary department at Bryn Mawr Medical Specialists Association is in need of a part-time Precertification Specialist to join their growing team. The ideal candidate will be experienced in precertifications, billing, and prior authorization. This person will be responsible for all office related precerts. However, candidates with less experience but a willingness to learn are encouraged to apply!

Responsibilities:

• Reviewing chart documentation to ensure patient meets medical policy guidelines
• Prioritizing incoming authorization requests according to urgency
• Obtaining authorization via payer website or by phone and following up regularly on pending cases
• Maintaining individual payer files to include up to date requirements needed to successfully obtain authorizations
• Initiating appeals for denied authorizations
• Confirming the accuracy of CPT and ICD-10
• Coordinating and confirming insurance coverage and payments on prescriptions, procedures, and other services

Qualifications:

• Precertification experience
• Prior authorization experience
• Insurance verification experience
• Experience working with multiple health insurances
• High School Diploma or equivalent

The potential base pay range for this position is $18-$20 per hour. 

The pay listed in this job posting is a good faith determination of potential base compensation that may be offered and is not a guarantee of a particular wage. Actual base pay will vary and is commensurate with the applicant’s knowledge, experience, education, skills, training, certifications, and qualifications required for the role.  In addition, the listed pay range is based on factors at the time of this job posting and may be modified in the future based on market data, internal equity, and the budget of the department hiring for this position.  Final compensation and benefit eligibility may vary by role and employment status and will be confirmed at the time of offer.  Benefits, PTO, and Holiday Pay are only available to employees working 24 hours or more per week.