Precertification Prior Authorization Spec, Spn-Scheduling

Job Details

Job Location: Professional Building

Department: SPN – Scheduling

Schedule: Full Time, 8‑hour day shift, 08:00–17:00 Monday‑Friday

Responsible for obtaining precertification and/or prior authorization for each patient for which testing and/or procedures have been ordered by the Surgeon, prior to services being rendered. All authorization must be obtained preferably before the scheduled appointment; if not, the specialist must contact the patient to reschedule. Duties also include reviewing the accuracy of information and supporting documents, uploading authorization numbers and related documentation into the SGMC EHR software system, monitoring and tracking authorization requests, documenting in the official medical record, contributing to department development, performing front‑office reception and various customer‑service duties, and completing tasks assigned by the Practice Manager.

• High school graduate preferred; minimum one year of administrative experience or equivalent, preferably in a hospital or medical office setting.
• Working knowledge of insurance and managed care.
• Excellent computer skills – PC, Windows, Microsoft Office (Outlook, Word, Excel) and related office equipment.
• Prior use of medical office software database preferred.
• Excellent communication and interpersonal skills; ability to work effectively as part of a team.
• Self‑motivated, with initiative to tackle important issues and tasks.
• Attention to detail and ability to manage multiple tasks, meet deadlines, and adapt to changing circumstances.
• Flexibility to cross‑train to other functions as necessary.
• Ability to handle moderate heavy lifting (0–25 lbs.) and use office equipment such as fax, copier, and computer.

• Low healthcare insurance premiums
• 401(k) with employer match
• Paid Time Off (PTO)
• Employee discounts
• Company‑paid life insurance
• Short‑term and long‑term disability coverage
• Cancer insurance
• Accident insurance
• Pet insurance
• Tuition reimbursement
• On‑the‑job training and skills development
• Opportunities for growth and advancement
• Employee Assistance Program

The role requires a regular work schedule during normal office hours in an indoor setting. The applicant must be comfortable with prolonged sitting, moderate heavy lifting (up to 25 lbs.), reaching, stooping, pushing, pulling, bending, and twisting, and operating office equipment such as fax, copier, and computer. The position may involve a moderate level of stress.