Precertification Specialist- Retina (48231)

CEENTA is the premier eye, ear, nose, and throat group in the Carolinas, committed to exceptional patient care, operational excellence, and a collaborative team environment.

We are seeking a detail-oriented Precertification Specialist to support our Revenue Cycle team by verifying insurance benefits, obtaining prior authorizations, and ensuring patients are well informed prior to services.

• Verify and confirm patient insurance benefits via online portals and phone calls
• Obtain prior authorizations and referrals as required by payer plans, with ongoing follow-up when needed
• Communicate benefit details, coverage, and expected pre-payments clearly to patients
• Communicate with provider offices and internal teams to resolve authorization and benefit issues
• Enter patient pre-payments into Epic accurately and timely
• Prioritize assigned work queues by date of service, payer, and procedural requirements
• Monitor emails, in-basket messages, voicemails, and scanned faxes daily
• Identify potential systemic or payer-related issues and escalate them to leadership as appropriate

Monitor authorization and benefit verification work queues, contact payers, communicate with patients regarding pre-service payments, respond to emails and in-basket messages, process incoming faxes, and collaborate with provider offices to ensure all scheduled services are authorized and financially cleared prior to the date of service.

Hybrid/Remote, Full-time, 40 hours per week. Monday–Friday with hours ranging between 7:00 a.m. and 6:00 p.m.

Remote/Home Office environment. Employees must have a dedicated, HIPAA-compliant workspace with high-speed internet and sufficient space for two monitors. The ability to work independently, manage time effectively, and remain productive in a remote setting is required.

Travel is not required for this position, except for training or occasional in-person staff meetings as needed.

• High school diploma or GED required
• Minimum of 2 years of experience in a medical field
• At least 1 year of precertification or prior authorization experience preferred
• Understanding of payer medical policies and prior authorization guidelines
• Strong attention to detail and ability to manage a high-volume, time-sensitive workload
• Excellent customer service and communication skills
• Ability to multitask, problem-solve, and work independently
• Epic experience preferred but not required