| Location | Binghamton |
| Salary | $18.27–$28.50 Per Hour |
Pre-Certification Coordinator IEvery authorization you obtain helps move patient care forward. As a Pre-Certification Coordinator I, you'll collaborate with providers, insurance companies, and patients to ensure timely approvals that support exceptional care and positive outcomes.Why Choose Guthrie:Voluntary 403(b) Retirement PlanPlan for your future with Fidelity investment optionsEmployee Assistance ProgramConfidential support for personal and professional well-beingShift Differentials & PremiumsEarn more for evenings, nights, weekends, and float coveragePTO Starts on Day 1Friendly, Inclusive Work FamilyBe part of a team that feels like homeRecognized as a Top Healthcare Employer: Guthrie is consistently recognized for its strong workplace culture and commitment to caregiver well-being, including:Best Places to Work 2025 - Modern HealthcareAmerica's Greatest Workplaces in Healthcare 2025, 2026 - NewsweekAmerica's Best-In-State Employers (PA) 2025 - ForbesAmerica's Best Employers for Healthcare Professionals 2025 - ForbesAmerica's Best Employers for Women 2025ForbesSchedule & Coverage:Full Time, Day Shift, Hybrid work settingPosition SummaryUnder general supervision, performs standardized authorization and financial clearance activities for Guthrie. This position focuses on routine to moderately complex authorization tasks, payer communications, and documentation while following established workflows, payer guidelines, and departmental procedures. Maintains an initial prior authorization & eligibility denial rate below 7%.Position RequirementsHigh School Diploma or equivalentProficiency with computers and online portalsExcellent communication skillsAbility to function as a cooperative and positive team memberExperience & SkillsBasic knowledge of prior authorization and insurance terminologyStrong attention to detailAbility to follow established proceduresEffective written and verbal communication skillsScope & ComplexityHandles routine and standardized authorization workflowsWorks within clearly defined payer rules and protocolsEscalates complex issues, denials, or exceptions to senior staff or leadershipRequires guidance for nonstandard casesEssential FunctionsInsurance Verification & Coverage SupportVerifies insurance eligibility and benefit coverage prior to scheduled services using Epic and Payer Portals.Confirms active coverage dates, plan requirements, and authorization dependencies to ensure services are financially cleared.Performs eligibility rechecks as needed when service dates change; coverage appears inactive, or payer responses require validation.Identifies discrepancies in coverage or eligibility and escalates issues per established workflows.Documents eligibility verification and benefit details accurately in the electronic health record.Authorization & Coverage ActivitiesObtains initial insurance authorizations for all admissions and visits including notice of admission for elective IP stays and all VA admissions, including ER and OBS as applicable.Submit authorization requests using payer portals, fax, or phone based on defined requirements.Enters authorization numbers and coverage details into the electronic health record.Reviews schedules to confirm authorization coverage supports planned services.Follow up on pending authorizations using established timelines.Documentation & CommunicationDocuments payer determination accurately and timely.Communicates authorization status to clinical staff and case management.Notifies leadership of authorization delays or missing information.Maintains complete and compliant patient account documentation.Systems & ToolsUses Epic, payer portals, and standard office applications.Works assigned work queues and portals under supervision.Follows departmental workflows and documentation standards.Other DutiesOther duties as assigned.The pay range for this position is $18.27-$28.50/hr. based on experience.