Preauthorization/Precertification Specialist

  • Full-time

Highlights

Join East Tennessee Gastroenterology PLL as a Preauthorization/Precertification Specialist, where you will play a vital role in ensuring smooth patient care processes. This position is perfect for detail-oriented professionals who thrive in a fast-paced environment and are passionate about supporting healthcare services in the Cleveland, TN area.

Numbers & Facts

LocationCleveland, TN
Job TypeFull-time

Description

Benefits:
  • 401(k)
  • 401(k) matching
  • Free food & snacks
  • Paid time off

About the Role:
Join East Tennessee Gastroenterology PLL as a Preauthorization/Precertification Specialist, where you will play a vital role in ensuring smooth patient care processes. This position is perfect for detail-oriented professionals who thrive in a fast-paced environment and are passionate about supporting healthcare services in the Cleveland, TN area.



Responsibilities:
  • Review and process preauthorization and precertification requests for medical procedures and services.
  • Communicate effectively with insurance companies, healthcare providers, and patients regarding authorization status.
  • Maintain accurate records of all preauthorization activities and outcomes in the electronic health record system.
  • Collaborate with clinical staff to gather necessary documentation for authorization submissions.
  • Monitor pending authorizations and follow up as needed to ensure timely approvals.
  • Stay updated on insurance policies and changes to ensure compliance and accuracy.
  • Assist in resolving any authorization-related issues or denials with appropriate follow-up actions.
  • Provide exceptional customer service to patients and healthcare providers throughout the authorization process.
Requirements:
  • High school diploma or equivalent; relevant certification in medical billing or coding is a plus.
  • Minimum of 2 years of experience in healthcare insurance verification or preauthorization roles.
  • Strong knowledge of medical terminology and coding (CPT, ICD-10).
  • Excellent communication skills, both verbal and written, with a customer-focused approach.
  • Proficient in using electronic health record systems and Microsoft Office Suite.
  • Detail-oriented with strong organizational and time management skills.
  • Ability to work independently and as part of a team in a fast-paced environment.
  • Demonstrated ability to handle sensitive information with confidentiality and professionalism.
About Us:
East Tennessee Gastroenterology PLL has been serving the Cleveland, TN community for over a decade, providing top-notch gastrointestinal care. Our dedicated team is known for their compassionate approach and commitment to patient satisfaction, making us a trusted choice for both patients and employees alike.

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