Job Description

Job Description

POSITION SUMMARY: We are seeking a detail-oriented and experienced Insurance Pre-Cert Specialist to join our team. In this role, you will be responsible for verifying patient insurance eligibility, updating insurance and demographic information, determining prior authorization requirements, and obtaining all necessary authorizations for sleep studies. You will manage multiple electronic work queues while collaborating with both internal and external customers, including patients, families, third-party payers, clinical staff, hospital access departments, and referring offices. This position involves high-volume work and requires a strong ability to handle a variety of tasks efficiently.

Key Responsibilities:

• Verify patient insurance eligibility and ensure all demographic information is up to date.
• Identify prior authorization requirements and secure necessary approvals for sleep studies.
• Manage and track progress in multiple electronic work queues.
• Collaborate with internal and external teams, including patients, families, insurance providers, and clinical staff, to obtain required documentation.
• Provide support to referring offices to facilitate smooth processing of certifications and authorizations.
• Ensure compliance with insurance guidelines and regulations for sleep study certifications.

Education & Experience Requirements:

• High school diploma or GED preferred.
• Minimum of 2 years of experience in healthcare or a related field, with a focus on insurance prior authorization and referral processes.
• Experience in a Sleep Program setting is preferred.

Job Type: Full-time, Position requires to be onsite in our Irving, Tx site for initial 90 days and eligible to go remote after successfully completing the probationary period. 

Schedule:

• Monday to Friday

Benefits:

• Dental insurance
• Disability insurance
• Flexible spending account (FSA)
• Health insurance
• Health savings account (HSA)
• Life insurance
• Paid time off (PTO)
• Vision insurance

Experience Required:

• Insurance verification: 2 years (Required)

How to Apply: If you are an experienced Insurance Pre-Cert Specialist looking for a rewarding remote position, apply today to join our team!

Job Tags

Similar Jobs