Precertification Specialist

Job Details Description Join Our Team! Cataract & Laser Institute is seeking a detail-oriented and dependable Precertification Specialist to join our team. In this role, you will help ensure patients receive timely access to surgical care by coordinating insurance eligibility, benefits, precertifications, and prior authorizations. You will serve as an important connection between patients, providers, surgical teams, clinic staff, and insurance companies—helping create a seamless, compassionate, and efficient experience from scheduling through surgery. What You’ll Do Obtain insurance precertifications and prior authorizations for surgical procedures. Verify patients’ insurance eligibility, benefits, coverage requirements, and financial responsibility. Review scheduled procedures and supporting clinical documentation to ensure payer requirements are met. Submit accurate authorization requests with the appropriate medical records and supporting documentation. Communicate with insurance companies regarding authorization status, additional documentation requests, denials, and appeals. Coordinate with surgeons, surgical schedulers, clinic teams, billing staff, and patients to resolve authorization or coverage concerns. Maintain accurate and timely documentation within the electronic medical record and other applicable systems. Monitor pending authorizations, expiration dates, and renewal requirements to prevent delays or cancellations. Assist with resolving denied or delayed authorization requests. Stay informed of payer-specific guidelines, authorization requirements, and regulatory changes. Protect patient confidentiality and maintain compliance with HIPAA and organizational policies. Provide professional, compassionate service when communicating with patients and internal teams. What We’re Looking For High school diploma or equivalent required; associate degree in healthcare administration or a related field preferred. Previous experience with insurance verification, prior authorizations, precertification, medical billing, or healthcare administration preferred. Knowledge of medical terminology, insurance plans, CPT codes, and ICD-10 codes preferred. Strong attention to detail and a commitment to maintaining accurate documentation. Excellent organizational, time-management, and problem-solving skills. Ability to prioritize multiple requests and meet deadlines in a fast-paced environment. Strong written and verbal communication skills. Comfortable communicating with patients, insurance representatives, providers, and clinical teams. Proficiency with electronic medical records, Microsoft Office, and other healthcare-related systems. Ability to work independently while contributing to a collaborative team environment. Why Join Cataract & Laser Institute? Competitive compensation Medical, dental, and vision insurance 401(k) with company match Paid time off and paid holidays Company-paid life insurance Supportive and team-focused work environment Opportunities to develop your knowledge and grow within the organization PHYSICAL DEMANDS AND WORK ENVIRONMENT (per ADA Guidelines) Physical Activity: Standing for sustained periods of time, Stooping, Grasping, Lifting, Talking, Hearing. Physical requirements: Light work. Must be able to lift up to 15 lbs on a regular basis from floor to waist, 5 lbs from waist to shoulder, and 5 lbs from shoulder to overhead. The worker is required to have close visual acuity to perform each activity. The worker may be exposed to the following hazards: Blood borne pathogens Communicable diseases Chemicals Steam Pressurized cylinders Sharp objects Moving parts of equipment Make an Impact As a Surgical Precertification Specialist, your accuracy, persistence, and communication will directly support our patients and surgical teams. By helping resolve insurance requirements before the day of surgery, you will reduce delays, improve the patient experience, and help ensure each patient receives the care they need. Cataract & Laser Institute is an Equal Opportunity Employer. #J-18808-Ljbffr