Precertification Specialist
Smyrna, GA
Category: Healthcare
Reference ID: 10078735
Shortcut: http://addisongroup.gosnaphop.com/bvN5Z4
Job Title: Precertification Specialist
Location: Smyrna, GA
Compensation: $22.00 per hour
Employment Type: Contract-to-Hire fully onsite
Schedule: Monday-Friday, 8:00 AM-5:00 PM
Benefits: This position is eligible for medical, dental, vision, and 401(k) benefits.
About the Opportunity
Addison Group is partnering with a well-established gastroenterology and hepatology practice to identify an experienced Precertification Specialist for a contract-to-hire opportunity within its Revenue Cycle department.
This position will support a growing precertification team responsible for verifying insurance coverage, obtaining prior authorizations, and ensuring scheduled diagnostic services are financially cleared before the patient's appointment. The department is currently rebuilding its workflows and expanding its team, making this an excellent opportunity for someone who is dependable, analytical, teachable, and interested in joining a collaborative healthcare environment.
Key Responsibilities
- Obtain, track, and manage prior authorizations for scheduled diagnostic testing and physician services.
- Verify patient insurance eligibility, benefits, coverage, and authorization requirements before services are rendered.
- Work with commercial and government insurance payers, including Blue Cross Blue Shield and UnitedHealthcare.
- Review scheduled services and identify authorization, eligibility, or coverage issues that could delay patient care or reimbursement.
- Calculate and communicate patient financial responsibility estimates when applicable.
- Perform pre-service collection activities and help secure patient payments before scheduled services.
- Document all authorization, eligibility, and account activity accurately within Epic.
- Utilize payer portals, clearinghouses, spreadsheets, and other systems to research and complete precertification requests.
- Collaborate with scheduling, clinical, billing, and financial teams to ensure patients are cleared for service.
- Follow up with insurance carriers regarding pending or denied authorization requests.
- Maintain productivity expectations of approximately 40-50 completed prior authorizations per day.
- Meet established quality, accuracy, attendance, and performance standards.
- Ensure compliance with organizational policies, payer guidelines, and regulatory requirements.
Qualifications
- High school diploma or GED required.
- Minimum of two years of experience in precertification, prior authorization, revenue cycle, insurance verification, or healthcare collections.
- Physician or professional-fee billing experience required.
- Previous experience obtaining prior authorizations for diagnostic testing or specialty physician services.
- Proficiency with Epic is required.
- Experience with Waystar or another healthcare clearinghouse is preferred.
- Strong knowledge of commercial insurance eligibility, benefits, and authorization requirements.
- Ability to work from spreadsheets, payer portals, and multiple healthcare systems.
- Excellent communication, customer service, and organizational skills.
- Ability to manage a high-volume workload while maintaining accuracy.
- Strong attendance, punctuality, and dependability are required.
Preferred Background
We are seeking candidates who are:
- Analytical thinkers who can research and resolve complex authorization issues.
- Good listeners who seek to understand instructions before responding.
- Open to peer-to-peer training, coaching, and workflow changes.
- Comfortable working within an innovative and diverse team.
- Professional, dependable, and able to adapt as the department continues to grow.
- Experienced within physician practices, specialty healthcare, gastroenterology, or another professional-fee environment.
About the Organization
The organization is one of the Southeast's oldest and largest medical practices specializing in adult gastroenterology and hepatology. It provides specialty care across several locations throughout the metropolitan Atlanta area and surrounding communities.
The Revenue Cycle department is currently being rebuilt and retrained, with workflows being redesigned to improve productivity and operational efficiency. The current department includes approximately 35 employees and is expected to grow to 45-50 team members.
Addison Group is an Equal Opportunity Employer. Addison Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Addison Group complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. Reasonable accommodation is available for qualified individuals with disabilities, upon request.
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