Prestige Staffing
Job Information
Job Title: Precertification Specialist
Location: Sandy Springs, GA (in-office, full time)
Pay: $25/hr
Job Type: Contract to hire
Hours: Mon-Fri, 8-5 (some flexibility)
Responsibilities Handling pre‑authorizations for oncology procedures.
Initiates verification of eligibility and plan benefits.
Notifies and authorizes all outpatient accounts.
Follows developed policies and procedures to obtain insurance benefits.
Contacts third‑party payers to verify eligibility.
Initiates pre‑authorization for out‑patient services.
Identifies correct insurance plan, financial class, and coordination of benefits.
Enters authorization documentation into appropriate systems.
Responsible for obtaining clinical authorization by communicating patient and clinical information, medical necessity, and level of care to payers to secure account for reimbursement.
Minimum Qualifications
High school diploma or equivalent.
Knowledge of drug HCPCS and diagnosis codes.
Ability to review physician notes in medical records.
Knowledge of government, managed care, and commercial insurance payer requirements to obtain authorization for treatment.
Typing skills and good communication skills.
Must pass criminal background and drug test (including tobacco).
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Responsibilities Handling pre‑authorizations for oncology procedures.
Initiates verification of eligibility and plan benefits.
Notifies and authorizes all outpatient accounts.
Follows developed policies and procedures to obtain insurance benefits.
Contacts third‑party payers to verify eligibility.
Initiates pre‑authorization for out‑patient services.
Identifies correct insurance plan, financial class, and coordination of benefits.
Enters authorization documentation into appropriate systems.
Responsible for obtaining clinical authorization by communicating patient and clinical information, medical necessity, and level of care to payers to secure account for reimbursement.
Minimum Qualifications
High school diploma or equivalent.
Knowledge of drug HCPCS and diagnosis codes.
Ability to review physician notes in medical records.
Knowledge of government, managed care, and commercial insurance payer requirements to obtain authorization for treatment.
Typing skills and good communication skills.
Must pass criminal background and drug test (including tobacco).
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