Precertification Representative
$45,760–$47,840 year
On-site · Princeton, New Jersey, United States
Job Summary
Precertification Representative position in an in-person medical office setting at Princeton Medical Group. Responsibilities include obtaining precertifications for tests/procedures, communicating with nursing staff about precertification requirements, staying updated on insurance guidelines, using systems to obtain precertifications, tracking denied-requests appeals, completing follow-up tasks, coordinating peer-to-peer sessions, and maintaining logs for review by doctors/nursing staff. Works Monday–Friday 8:30 AM–5:00 PM with possible overtime; location is Princeton, NJ. Requirements include precertification experience, strong customer service, knowledge of insurance and precertification processes, medical terminology, ability to interpret medical charts, and preferred ICD-10 billing experience. Healthcare setting includes outpatient medical office with multiple specialties; in-person role with travel not indicated.
Required Qualifications
- Previous precertification experience
- Excellent customer service skills
- Knowledge of insurances and precertification processes
- Knowledge of medical terminology and ability to interpret medical charts
- 1 year of experience with ICD-10 billing processes (Preferred)
Additional Requirements
- Pre-employment drug screen is required
- Pre-employment professional reference check is required
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