Precertification Specialist (47226)

Why Join CEENTA

CEENTA is the premier eye ear nose and throat group in the Carolinas committed to exceptional patient care operational excellence and a collaborative team environment.

We are seeking a detail-oriented Precertification Specialist to support our Revenue Cycle team by verifying insurance benefits obtaining prior authorizations and ensuring patients are well informed prior to services.

What You Will Do

• Verify and confirm patient insurance benefits via online portals and phone calls
• Obtain prior authorizations and referrals as required by payer plans with ongoing follow-up when needed
• Communicate benefit details coverage and expected pre-payments clearly to patients
• Communicate with provider offices and internal teams to resolve authorization and benefit issues
• Enter patient pre-payments into Epic accurately and timely
• Prioritize assigned work queues by date of service payer and procedural requirements
• Monitor emails in-basket messages voicemails and scanned faxes daily
• Identify potential systemic or payer-related issues and escalate them to leadership as appropriate

A Typical Day

Monitor authorization and benefit verification work queues contact payers communicate with patients regarding pre-service payments respond to emails and in-basket messages process incoming faxes and collaborate with provider offices to ensure all scheduled services are authorized and financially cleared prior to the date of service.

Schedule

Hybrid/Remote Full-time 40 hours per week. MondayFriday with hours ranging between 7:00 a.m. and 6:00 p.m.

Work Environment

Remote/Home Office environment. Employees must have a dedicated HIPAA-compliant workspace with high-speed internet and sufficient space for two monitors. The ability to work independently manage time effectively and remain productive in a remote setting is required.

Travel

Travel is not required for this position except for training or occasional in-person staff meetings as needed.

What Youll Bring

• High school diploma or GED required
• Minimum of 2 years of experience in a medical field
• At least 1 year of precertification or prior authorization experience preferred
• Understanding of payer medical policies and prior authorization guidelines
• Strong attention to detail and ability to manage a high-volume time-sensitive workload
• Excellent customer service and communication skills
• Ability to multitask problem-solve and work independently
• Epic experience preferred but not required