PRECERTIFICATION SPECIALIST (11018)

Verify patient insurance benefits and obtain pre-authorization for medical services before procedures are rendered. Confirm eligibility across carriers such as Medicare, Medicaid, and commercial plans, then gather necessary documentation from physicians and clinical staff to support authorization requests. Act as a liaison between patients, doctors, insurance representatives, and facility staff to communicate coverage details, explain financial responsibilities, and resolve issues with pending authorizations or denials. Accurately document all interactions and maintain records within the practice management system.