PRECERTIFICATION/AUTHORIZATION SPECIALIST

Company: MUSC Health & Medical University of SC
Location: Awendaw
Posted on: October 30, 2024

Job Description:

Job Description Summary
Responsible for verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to the delivery of inpatient, outpatient, and ancillary services. This individual determines which patient services have third party payer requirements and is responsible for obtaining the necessary authorizations for care, via phone, fax, or payer websites.

Entity
Medical University Hospital Authority (MUHA)

Worker Type
Employee

Worker Sub-Type
Regular

Cost Center
CC002349 CHSCorp - Precertification Unit - (19920200)

Pay Rate Type
Hourly

Pay Grade
Health-20

Scheduled Weekly Hours
40

Work Shift

Job Description
Responsible for verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to the delivery of inpatient, outpatient, and ancillary services. This individual determines which patient services have third party payer requirements and is responsible for obtaining the necessary authorizations for care, via phone, fax, or payer websites. The Specialist provides detailed and timely communication to both payers and clinical partners in order to facilitate compliance with payer contractual requirements and is responsible for documenting the appropriate information in the patient's record. Other duties as assigned.

Additional Job Description
Education: High School Degree or Equivalent Work Experience: 1 year

If you like working with energetic enthusiastic individuals, you will enjoy your career with us!

The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.

Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: http://www.uscis.gov/e-verify/employees

Keywords: MUSC Health & Medical University of SC, Charleston , PRECERTIFICATION/AUTHORIZATION SPECIALIST, Other , Awendaw, South Carolina