Job Title: Pre-Certification Specialist  

Location: Charlotte, NC 28210

Hours: Mon-Fri, 8am-5pm 

Must Haves: 

• 3+ years of experience in pre-certification, prior authorization, or a related healthcare scheduling role.
• Epic experience is required, specifically working with referrals and navigating Epic workflows between systems.
• Strong understanding of insurance verification, prior authorizations, and CPT codes.
• Experience scheduling procedures and managing authorization requirements.
• Ability to work independently with minimal training and quickly ramp up in a fast-paced environment.

Day to Day:

This individual will receive referrals from provider offices and prioritize authorization requests based on procedure type and urgency. They will research insurance requirements, submit prior authorizations using the appropriate CPT codes, verify coverage, and ensure all authorization requirements are met before scheduling procedures. The role is heavily focused on coordinating outpatient surgeries, managing scheduling logistics, and working within Epic to track referrals, authorizations, and appointments. The specialist will also collaborate with clinical and administrative teams to ensure a smooth patient experience and timely completion of all pre-procedure requirements.