PreCert Specialist - Full-Time - Germantown, TN

Job description

Job Title: PreCert Specialist About Us: West Cancer Center is a comprehensive, patient-centered cancer care and research institution committed to compassionate care, innovation, and clinical excellence. Our multidisciplinary teams deliver integrated care tailored to the needs of each individual and their loved ones. Position Overview: The PreCert Specialist plays a critical role as the front-line defense ensuring that patients have the required precertification for procedures, drugs, and radiology services. This position is also responsible for entering patient information into the system. The PreCert Specialist serves as a key resource for patients, providers, and staff by navigating insurance requirements, obtaining authorizations, and ensuring accurate documentation. Key Responsibilities: - Verify demographic and insurance information including co-pays, deductibles, stop losses, guarantors, subscribers, and medical policy requirements - Update demographic and insurance records in a timely and accurate manner - Obtain and review physician orders for medical necessity and coverage requirements - Research insurance coverage criteria using payer policies, medical literature, and com...