Lead Precertification Specialist

Lead Precertification Specialist

Lead Precertification Specialist

Charleston, South Carolina

Patient Access, Records, Health Information, Medical Records & Coding

Business Operations

Full Time

Hospital Authority (MUHA)

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.

Entity: Medical University Hospital Authority (MUHA)

Worker Type: Employee

Worker Sub-Type: Regular

Cost Center: CC002349 CHSCorp - Precertification Unit

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

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.