Pre-Certification Specialist
Houston, TX
Category: Healthcare
Reference ID: 10064404
Shortcut: http://addisongroup.gosnaphop.com/HKXR0n
Job Title: Pre-Certification Specialist (Hybrid)
Location: Houston, TX, (Galleria Area)
Industry: Healthcare
Pay: $21–$24/Hourly
Job Type: Contract-to-Hire
Benefits: This position is eligible for medical, dental, vision, and 401(k)
About Our Client:
Addison Group is partnering with a healthcare organization seeking an experienced Precertification Specialist to support high-volume authorization workflows. This role is ideal for someone with strong procedural authorization experience who thrives in a fast-paced, detail-driven environment and is comfortable collaborating with payors, providers, and internal teams.
Job Description:
The Precertification Specialist will be responsible for obtaining and managing prior authorizations for procedures, diagnostic testing, and surgical cases. This role requires strong clinical review skills, excellent communication, and the ability to manage a high daily volume of requests while maintaining accuracy and compliance.
Key Responsibilities:
- Obtain and document prior authorizations for procedures, diagnostics, office visits, and surgical cases.
- Act as a liaison between payors, physician offices, and patients to coordinate authorization requirements.
- Verify insurance eligibility and benefits, ensuring accurate documentation in EMR systems.
- Review clinical documentation and diagnosis codes to support authorization submissions.
- Communicate directly with payors to address authorization questions or requests for additional information.
- Manage a high-volume workload (40–45 authorization requests per day once fully trained).
- Pull data from EMR systems and track activity using Excel spreadsheets.
- Identify and correct account discrepancies and maintain clear communication with stakeholders.
- Meet established productivity benchmarks (30+ authorizations per day after ramp-up).
- Assist with additional precertification and administrative tasks as needed.
Qualifications:
- 3+ years of prior authorization/precertification experience required, with a strong focus on procedures.
- Facility experience preferred; professional billing background also considered.
- Strong understanding of clinical documentation, diagnosis codes, and EOB review.
- Experience working within EMR systems and multiple payer platforms.
- Proficient in Microsoft Excel, including data tracking and reporting.
- Ability to multitask, work independently, and meet deadlines in a fast-paced environment.
- Strong verbal and written communication skills.
Additional Details:
- Schedule: Flexible hours between 6:00am–6:00pm
- Work Model:
- Training period: Onsite
- Post-training: Hybrid (3 days onsite / 2 days remote)
- Start Date: ASAP
- Environment: Fast-paced, collaborative business office
Perks:
- Hybrid schedule with flexibility after training
- Opportunity to gain specialized authorization experience
- Supportive leadership and team-oriented environment
Addison Group is an Equal Opportunity Employer. Addison Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Addison Group complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. Reasonable accommodation is available for qualified individuals with disabilities, upon request.
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