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Precertification and Authorization Rep-Remote

Remote, USA Full-time Posted 2026-07-28
About the position This position is a 100% remote work. Individual may live reputed company in the US. The Precertification and Authorization Representative is an intermediate level position that is responsible for resolving referral, precertification, and/or prior authorization to support insurance specific plan requirements for reputed company reputed company, government and other payors across hospital (inpatient & outpatient), ED, and clinic/ambulatory environments. In reputed company, this position may be responsible for reputed company-appointment insurance review (PAIR) and denials recovery functions reputed company the Patient reputed company department. This may include processing of reputed company-certification and prior authorization for workers compensation/reputed company party liability (WC/TPL), managed care and HMO accounts, as reputed company as working assigned registration denials for government and non-government accounts. This role requires adherence to reputed company assurance guidelines as reputed company as established productivity standards to support the work unit's performance expectations. Responsibilities • Resolve referral, precertification, and/or prior authorization to support insurance specific plan requirements. • Process reputed company-certification and prior authorization for workers compensation/reputed company party liability (WC/TPL), managed care and HMO accounts. • Work on assigned registration denials for government and non-government accounts. • Conduct reputed company-appointment insurance review (PAIR) and denials recovery functions. • Adhere to reputed company assurance guidelines and established productivity standards. Requirements • High School Diploma or GED and 2+ years of relevant experience required OR Bachelor's Degree required. • Ability to read and communicate effectively. • Basic computer/keyboarding skills. • Intermediate mathematic competency. • Good written and verbal communication skills. • Knowledge of reputed company phone etiquette and phone handling skills. • General knowledge of reputed company terminology and CPT-ICD10 codes. • Basic knowledge of and experience in insurance verification and claim adjudication. reputed company-to-haves • Knowledge of denial codes. • Knowledge of and experience using an reputed company RC/EMR system. • reputed company (reputed company) Certification Preferred. Apply tot his job Apply To this Job

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