What are the responsibilities and job description for the Precertification/Authorization Specialist position at MUSC Health?
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.
MUSC Health is a leading academic health system offering a robust and comprehensive benefits package, including health insurance, retirement plan options, wellness resources, and more.
Entity
Medical University Hospital Authority (MUHA)
Worker Type
Employee
Worker Sub-Type
Regular
Cost Center
CC002349 SYS - Precertification Unit
Pay Rate Type
Hourly
Pay Grade
Health-20
Scheduled Weekly Hours
40
Work Shift
Job Description
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
High school diploma or equivalent (GED) and two years work experience in hospital registration, insurance, or financial counseling required; a bachelor's degree may be substituted for the required work experience.
Previous work experience in pre-certification and knowledge of medical terminology highly preferred.
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
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.
MUSC Health is a leading academic health system offering a robust and comprehensive benefits package, including health insurance, retirement plan options, wellness resources, and more.
Entity
Medical University Hospital Authority (MUHA)
Worker Type
Employee
Worker Sub-Type
Regular
Cost Center
CC002349 SYS - Precertification Unit
Pay Rate Type
Hourly
Pay Grade
Health-20
Scheduled Weekly Hours
40
Work Shift
Job Description
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
High school diploma or equivalent (GED) and two years work experience in hospital registration, insurance, or financial counseling required; a bachelor's degree may be substituted for the required work experience.
Previous work experience in pre-certification and knowledge of medical terminology highly preferred.
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