Pre-Cert Specialist

Pre-Cert Specialist - REPORTS TO: Billing Supervisor, Practice Manager and Physicians.

DEFINITION OF POSITION: Responsible for obtaining pre-certifications from various insurance companies for test, procedures and surgeries.


  1. High school graduate.
  2. Able to read, write, and communicate.
  3. Displays a primary interest in giving good patient care and maintaining standards of courtesy and friendliness to co-workers.
  4. Maintain BLS certification.
  5. Able to comply with patient confidentiality and integrity policy on all matters.
  6. Certification encouraged.
  7. Knowledge of medical terminology


  1. Monitor scheduled procedures and maintain organized list with status of pre-certifications
  2. Verify insurance eligibility benefits via phone and/or internet access.
  3. Update insurance policy information in EMR
  4. Check insurance payment policy for scheduled procedures and obtain prior authorization.