Pre-Certification Coordinator I – Single Business Office

• Collaborate with providers, insurance companies, and patients to ensure timely approvals that support exceptional care and positive outcomes
• Perform standardized authorization and financial clearance activities for Guthrie
• Maintain an initial prior authorization & eligibility denial rate below 7%
• Verify insurance eligibility and benefit coverage prior to scheduled services using Epic and Payer Portals
• Obtain initial insurance authorizations for all admissions and visits including notice of admission for elective IP stays and all VA admissions
• Submit authorization requests using payer portals, fax, or phone based on defined requirements
• Document payer determination accurately and timely

• High School Diploma or equivalent
• Proficiency with computers and online portals
• Excellent communication skills
• Ability to function as a cooperative and positive team member
• Basic knowledge of prior authorization and insurance terminology
• Strong attention to detail
• Ability to follow established procedures
• Effective written and verbal communication skills

Demonstrates proficiency in prior authorization processes and insurance verification, ensuring timely approvals and maintaining low denial rates. Excels in communication and teamwork to support exceptional patient care and positive outcomes.

• Prior Authorization Knowledge
• Insurance Eligibility Verification
• Attention to Detail
• Effective Communication Skills
• Proficiency with Epic

• Prior Authorization
• Insurance Verification
• Financial Clearance Activities
• Documentation
• Payer Portals

• Team Collaboration
• Positive Attitude
• Attention to Detail
• Effective Communication

• Insurance Terminology
• Authorization Requests
• Denial Rate Management

• Epic
• Payer Portals