Clinical Authorization Specialist

1 week ago


Bainbridge, United States Memorial hospital AND MANOR Full time
Precertification Specialist Job Description

At Memorial Hospital and Manor, we are seeking a skilled Precertification Specialist to join our Utilization Management team.

The successful candidate will be responsible for performing precertification, certification, and authorization activities as part of our daily operations within the Clinical Effectiveness model.

Key Responsibilities:
  • Initial certification and collection of necessary information to initiate and/or complete authorizations as required by assignment/procedure
  • Regulatory compliance and related denial management issues
  • Associated tracking and reporting efforts
  • Liaison between MHM Medical staff and personnel, and third-party payers

This position reports directly to the PAS Manager and requires a minimum of 2 years of proven work experience in utilization management and/or healthcare.

Qualifications include a High School Diploma or equivalent, with an Associate degree preferred.



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