Precertification Specialist

Pavilion 1, BC, Canada

Full-time

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Job details

Job type: Full-time
Posting language: English
Posted: Sep 28, 2026

Original job description

Position Title

Precertification Specialist

Olathe Medical Pavilion A

Position Summary / Career Interest

The Pre-Reg/Pre-Cert Specialist is responsible for identifying patients who qualify for pre-registration to include all new patients and all return patients. This position obtains identification to assure accuracy of demographic and insurance information and enters all information into the registration system. The Pre-Reg/Pre-Cert Specialist is responsible for pre-service collections and documentation when applicable. This role is responsible for verification and pre-certification, notification and authorization of all admissions and / or outpatient visits. For all sponsored admissions, will contact patients' employer and/or insurance company to verify coverage and benefits, obtain benefit level, patient liability, billing address.

Note: Schedule is Monday thru Friday 8:30am-5:00pm

Responsibilities And Essential Job Functions

Works reports daily according to duty specifications to retrieve all un-contacted patients prior to service. Utilizes worklists to pre-register / pre-certify hospital services.
Conducts telephone interviews as needed with patients to elicit demographic information and third-party payer data that will be needed for billing purposes.
Enters patient data directly into registration systems. Ensures that MSPQ is completed when appropriate.
Verifies with third party payor dependent eligibility, certificate and group numbers, co-payment and deductible amounts, statement mailing address, etc. Complies with Medicare / Medicaid and other insurance rules and regulations.
Works closely with the clinics, hospital ancillary departments, and patient financial advisors regarding potential complications regarding insurance coverage.
Secures accounts per established departmental policy. This includes but is not limited to, contacting the patient, contacting responsible payers including government and non-government payers, contacting the patient’s employer, referring uninsured and underinsured accounts to the Financial Advisors, and taking any other necessary actions. Contact provider office immediately of any restrictions denying services, such as inability to obtain pre-certification or any lock-in program by any agency.
Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department.
These statements are intended to describe the essential functions of the job and are not intended to be an exhaustive list of all responsibilities. Skills and duties may vary dependent upon your department or unit. Other duties may be assigned as required.

Required Education And Experience

High School Graduate or GED.

Preferred Education And Experience

1 or more years of experience in Epic.
1 or more years of prior experience in pre-registration or prior authorization.

Time Type

Full time

Job Requisition ID

R-57769

Important Information For You To Know As You Apply

The health system is an equal employment opportunity employer. Qualified applicants are considered for employment without regard to race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, ancestry, age, disability, veteran status, genetic information, or any other legally-protected status. See also Diversity, Equity & Inclusion.
The health system provides reasonable accommodations to qualified individuals with disabilities. If you need to request reasonable accommodations for your disability as you navigate the recruitment process, please let our recruiters know by requesting an Accommodation Request form using this link asktalentacquisition@kumc.edu.
Employment with the health system is contingent upon, among other things, agreeing to the health-system-dispute-resolution-program.pdf and signing the agreement to the DRP.

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More about this job

Responsibilities

Pre-register patients and verify demographic, insurance, eligibility, coverage, and benefit information in registration systems. Obtain pre-certifications and authorizations, document pre-service collections, coordinate with payers and clinical departments, and address coverage restrictions or financial concerns.

Requirements

A high school diploma or GED is required. One or more years of Epic experience and one or more years of pre-registration or prior authorization experience are preferred.

Skills

Pre-Registration
Pre-Certification
Insurance Verification
Prior Authorization
Patient Registration
Demographic Data Collection
Insurance Benefits Verification
Patient Financial Collections
Medical Billing
Medicare and Medicaid Compliance
Patient Communication
Epic

Visa sponsorship

Not detected in the job text

Keywords

Pre-Registration
Pre-Certification
Prior Authorization
Patient Registration
Epic
Insurance Verification
Eligibility Verification
Insurance Benefits
Demographic Information
Third-Party Payers
Patient Liability
Pre-Service Collections
Medical Billing
Medicare
Medicaid
Authorization
Admissions
Outpatient Visits
Worklists
Registration Systems
Financial Advisors
Coverage Restrictions

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