Precertification Specialist - UT Gastroenterology

Description:

University Physicians’ Association (UPA) is seeking a detail-oriented and customer-focused Precertification Specialist to join our UT Gastroenterology team. This is a fast-paced, specialty practice located within UT Medical Center, offering the opportunity to play a key role in ensuring patients receive timely, seamless care.

Position Summary

The Precertification Specialist serves as a vital liaison between patients, providers, and insurance companies. This role is responsible for verifying insurance benefits and eligibility, obtaining necessary authorizations, preparing procedure codes and estimates, and collecting prepayments when applicable—all with a strong focus on accuracy and patient service.

Key Responsibilities

• Monitor scheduled procedures and maintain an organized tracking list for precertification status
• Verify insurance eligibility and benefits via phone and online portals
• Obtain prior authorizations according to payer requirements
• Update insurance and policy details in the NextGen system
• Confirm receipt of all required authorization documentation prior to procedures
• Assign appropriate ICD-10 and CPT codes
• Communicate effectively with clinical and administrative staff to support timely procedures
• Perform additional duties as assigned to support the practice

Why Join UPA?

UPA offers a supportive team environment along with a comprehensive benefits package, including:

• Paid Time Off (PTO), Paid Holidays, and Sick Leave
• Medical, Dental, and Vision Insurance
• Short-Term and Long-Term Disability
• Life Insurance
• 401(k) with company match and immediate vesting
• Critical Illness coverage and more

If you enjoy working in healthcare, thrive in a detail-driven role, and value teamwork and stability, we’d love to hear from you!

Requirements:

Education, Training, and Experience

• Professional medical coding certification or a minimum of two years of related experience preferred
• Insurance verification experience required

Skills, Knowledge, and Abilities

• Maintains a professional and polished appearance
• Strong verbal communication and interpersonal skills
• Working knowledge of medical billing practices and managed care environments
• Familiarity with a variety of insurance plans and payer types
• Highly organized, detail-oriented, and self-motivated
• Proficient in Microsoft Office and Windows-based applications