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MUSC

Precertification Specialist-1

Career Insights for Eligibility Specialist

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What they do

An Eligibility Specialist provides assistance and information for people who apply for a government benefits program or health care program. Answers questions, assists with an application process, and reviews applications and relevant background information to determine eligibility. May assist eligible applicants with enrolling in a program.

$43,142 / year median in South Carolina

+20% projected growth

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Job Description

Job Description Summary MUSC Community Physicians (MCP) is an entity within the Medical University of South Carolina (MUSC) that provides healthcare to patients within the rural health network throughout the state of South Carolina. Responsible for verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to the delivery of inpatient, outpatient, and ancillary services. Entity MUSC Community Physicians (MCP) Worker Type Employee Worker Sub-Type​ Regular Cost Center
CC004513 MCP
- Revenue Cycle Pay Rate Type Hourly Pay Grade Health-20 Scheduled Weekly Hours 40 Work Shift Job Description Responsible for verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to the delivery of inpatient, outpatient, and ancillary services. This individual determines which patient services have third party payer requirements and is responsible for obtaining the necessary authorizations for care, via phone, fax, or payer websites. The Specialist provides detailed and timely communication to both payers and clinical partners in order to facilitate compliance with payer contractual requirements and is responsible for documenting the appropriate information in the patient's record. Other duties as assigned.
Education:
High School Degree or Equivalent Work Experience:
1 year
Additional Job Description Benefits:
Health, dental, vision, and life insurance Employer Sponsored Retirement Plan Paid time off and extended sick leave Paid Parental Leave Disability insurance plan options Continuous professional and clinical training Competitive pay Annual Merit Increase Wellbeing resources Tuition Reimbursement Employee perks and discounts Employee referral program Flexible schedule options Certification incentive program If you like working with energetic enthusiastic individuals, you will enjoy your career with us! The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need. Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: http://www.uscis.gov/e-verify/employees