Precertification Specialist

2 weeks ago

New Baltimore, United States Allied Digestive Health, LLC Full time
Albany Gastroenterology Consultants have partnered with Allied Digestive Health which is one of the largest integrated networks of gastroenterology care centers in the nation with over 200 providers and 60 locations throughout New Jersey and New York. As a fast-growing physician-led organization, our dynamic structure encourages physician input and decision-making, while simultaneously offering operational support. Our dedicated, compassionate team of providers prioritize personalized treatment plans for patients that deliver the highest quality of care. All of our doctors are board-certified in gastroenterology and hepatology. Several of them serve as chief of gastroenterology at nearby hospitals, and a number of them have been recognized as top-quality physicians in publications, including but not limited to: Best Doctors in America and Top Doctors New Jersey, and US News Health - US News & World Report.

We are excited to announce that we are looking for a Full-Time Precertification Specialist at Albany Gastroenterology Consultants of Albany New York

The Precertification Specialist Responsibilities are:
  • Knowledge of participating insurances and authorization requirements.
  • Responsible for obtaining complete and accurate insurance information, benefit verification, accurately interpreting benefit plans and investigating pertinent details.
  • Ability to verify patient eligibility and precertification requirements through online resources or via telephone.
  • Effectively communicate with families; when appropriate, regarding benefit details and limitations.
  • Documents detailed communication with payors and clinical support in the authorization fields.
  • Contacts family with any insurance issues that may prevent obtaining a referral/precertification.
  • Timely management of incoming responses.
  • Provide team coverage when needed.
  • Maintain professional and courteous demeanor at all times with patients, physicians and co-workers
  • Adhere to and support all policies and procedures of Albany Gastroenterology Consultants
  • Other responsibilities as assigned
The Precertification Specialist must have the following qualifications and experience:
  • High School graduate or equivalent
  • No experience is required, 1 to 3 years of experience is preferred as follows:
  • Experience in processing prior-authorizations and referrals is preferred.
  • Understands the concept of PCP and referrals protocols as defined by Insurance Carriers


We offer a competitive base salary, generous benefits, including: Medical, Dental, Vision, Life Insurance, Voluntary, Time-Off Benefits, EAP, 401K and Commuter Benefits.

Job Type: Full-Time Required Preferred Job Industries
  • Retail

  • Inpatient Care Specialist

    1 week ago

    Baltimore, Maryland, United States LifeBridge Health Full time

    Job OverviewWe are seeking an Inpatient Social Worker to join our team at LifeBridge Health. The successful candidate will work collaboratively with the clinical team and medical provider to provide patient and family advocacy, discharge planning coordination, and psychosocial intervention for high-risk inpatients.Key ResponsibilitiesAssess patients'...

  • Inpatient Social Care Specialist

    6 days ago

    Baltimore, Maryland, United States LifeBridge Health Full time

    About LifeBridge HealthAs a leading healthcare provider in Maryland, LifeBridge Health is committed to delivering exceptional care to our patients. With over 1 million patients served annually, we strive to CARE BRAVELY for the health and well-being of our community.Salary and BenefitsThe estimated salary for this role is $28.00-$49.00 per hour, based on...

  • Clinical Nursing Specialist

    1 week ago

    New York, New York, United States Weill Cornell Medicine Full time

    Job Summary:We are seeking a highly skilled Registered Nurse to join our team in the Nuclear Cardiology Operations department at Weill Cornell Medicine. The successful candidate will assist physicians with patient care, health education, and electronic medical record management.About Us:Weill Cornell Medicine is a comprehensive academic medical center...

  • Nurse Care Specialist

    1 week ago

    New Brunswick, New Jersey, United States Rutgers University Full time

    Rutgers University, a leading academic health center, seeks a skilled Licensed Practical Nurse for its Department of Surgery at Robert Wood Johnson Medical School. This exciting opportunity offers the chance to work with a talented team of healthcare professionals in providing top-notch care to patients undergoing colorectal surgery.Job OverviewThis...

  • Medical Professional

    1 week ago

    New York, New York, United States Weill Cornell Medicine Full time

    We are seeking a skilled and dedicated Registered Nurse to join our team at Weill Cornell Medicine, located in the heart of Manhattan. As a leading academic medical center, we are committed to providing exceptional patient care, conducting innovative research, and educating the next generation of healthcare professionals.Job SummaryThis role offers a unique...