Pre-Certification Specialist

2021, September 18
Pre-Certification Specialist 18th September 2021

Job Description

1. Contacts insurance companies to determine patient’s international insurance benefits. Verify patient eligibility and pre-certification requirements through On-line verification software, email or by telephone
2. Obtains requirements for claim submission and pre-certification process from insurance companies
3. Determines contract and benefit eligibility for pre-certification, prior authorization of inpatient and outpatient services
4. Works with patients in securing prepayment sources or financial agreements prior to providing service
5. Maintains the pre-certification related information in the system to ensure its accuracy
6. Verifies the coverage of benefit and asks for the payment guarantee in advance to expensive examinations for all outpatients
7. Assists patient on insurance coverage related matters
8. Responds to and follows through on patient and insurance related inquiries
9. Conducts financial screening for all inpatients (Observation, Day Surgery, Admission)
10. Coordinates and answers inpatient inquiries
11. Coordinates on discharge process, prepares itemized interim statement upondischarge
12. Serve as liaison with the insurance company, hospital and client.



1. Minimum education- Junior College
2. Medical background prefer
3. Working experience in health care organization or a business setting desired
4. Flexible to work third shifts
5. Additional education/experience may be substituted for experience/education


To apply

HR Ms. Ashley Wang

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