Independence Blue Cross
Pre-Certification Specialist (remote)
This job is now closed
Job Description
- Req#: 5105
Industry: Health Insurance Company
Why consider this job opportunity:
- Competitive pay and benefits package
- Opportunities for career advancement within the organization
- Positive and inclusive work environment
- Chance to contribute to the future of healthcare
- Commitment to employee learning and development
What to Expect (Job Responsibilities):
- Answer incoming calls from members and healthcare professionals regarding precertification requests
- Verify member eligibility and provider participation status
- Process precertification requests according to department guidelines
- Obtain and enter clinical information into computer systems
- Approve selected services and identify requests that require medical necessity review
What is Required (Qualifications):
- High school diploma required, associate degree in a related field preferred
- Minimum of three years of customer service experience in the health insurance or health services industry
- Knowledge of medical terminology, managed care delivery systems, and ICD9/ICD10 and CPT codes
- Strong organizational, interpersonal, verbal, and written communication skills
- Detail-oriented with the ability to adapt to changes
- Experience with computerized databases and software such as Word, Excel, and Mainframe
- Knowledge of INSINQ is a plus
How to Stand Out (Preferred Qualifications):
- Experience in the health insurance industry
- Familiarity with INSINQ
#healthinsurance #customer service #medicalterminology #managedcare #ICD9 #ICD10
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Talentify isn't the EOR for this position. Instead, our role in this specific opportunity is to link outstanding candidates with a top-tier employer.About the company
Independence Blue Cross is a health insurer based in Philadelphia, Pennsylvania, in the United States.
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