Precertification Specialist

About the role

Addison Group is partnering with a well-established gastroenterology and hepatology practice to identify an experienced Precertification Specialist for a contract-to-hire opportunity within its Revenue Cycle department.

Key Responsibilities

• Obtain, track, and manage prior authorizations for scheduled diagnostic testing and physician services.
• Verify patient insurance eligibility, benefits, coverage, and authorization requirements before services are rendered.
• Work with commercial and government insurance payers, including Blue Cross Blue Shield and UnitedHealthcare.
• Review scheduled services and identify authorization, eligibility, or coverage issues that could delay patient care or reimbursement.
• Calculate and communicate patient financial responsibility estimates when applicable.
• Document all authorization, eligibility, and account activity accurately within Epic.
• Utilize payer portals, clearinghouses, spreadsheets, and other systems to research and complete precertification requests.
• Collaborate with scheduling, clinical, billing, and financial teams to ensure patients are cleared for service.
• Follow up with insurance carriers regarding pending or denied authorization requests.
• Maintain productivity expectations of approximately 40-50 completed prior authorizations per day.
• Meet established quality, accuracy, attendance, and performance standards.
• Ensure compliance with organizational policies, payer guidelines, and regulatory requirements.

Qualifications

• A high school diploma or GED required.
• Minimum of two years of experience in precertification, prior authorization, revenue cycle, insurance verification, or healthcare collections.
• Physician or professional-fee billing experience required.
• Previous experience obtaining prior authorizations for diagnostic testing or specialty physician services.
• Proficiency with Epic is required.
• Experience with Waystar or another healthcare clearinghouse is preferred.
• Strong knowledge of commercial insurance eligibility, benefits, and authorization requirements.
• Ability to work from spreadsheets, payer portals, and multiple healthcare systems.
• Excellent communication, customer service, and organizational skills.
• Ability to manage a high-volume workload while maintaining accuracy.
• Strong attendance, punctuality, and dependability are required.

Preferred Background

• Analytical thinkers who can research and resolve complex authorization issues.
• Good listeners who seek to understand instructions before responding.
• Open to peer-to-peer training, coaching, and workflow changes.
• Comfortable working within an innovative and diverse team.
• Professional, dependable, and able to adapt as the department continues to grow.
• Experienced within physician practices, specialty healthcare, gastroenterology, or another professional-fee environment.

About the Organization

The organization is one of the Southeast's oldest and largest medical practices specializing in adult gastroenterology and hepatology. It provides specialty care across several locations throughout the metropolitan Atlanta area and surrounding communities. The Revenue Cycle department is currently being rebuilt and retrained, with workflows being redesigned to improve productivity and operational efficiency. The current department includes approximately 35 employees and is expected to grow to 45-50 team members.

Benefits

This position is eligible for medical, dental, vision, and 401(k) benefits.

Pay

$22.00 per hour

Schedule

Monday-Friday, 8:00 AM-5:00 PM

Employment Type

Contract-to-Hire fully onsite