Pre-Certification Specialist- 23 / hour!

Our client, a prominent healthcare organization in the Philly area, is seeking a contracted Precertification Specialist to join their team. This remote position supports members and healthcare professionals by processing precertification requests with accuracy, professionalism, and adherence to all regulatory requirements. Candidates must reside in the Tri-State area. About the Job Respond to high-volume inbound calls from members and healthcare professionals regarding precertification requests. Verify member eligibility and provider participation status across multiple systems, including the NPI Registry. Process precertification requests received via phone, fax, or online portal per departmental guidelines. Collect and enter clinical data such as procedure and diagnosis codes accurately into the system. Approve selected services based on departmental criteria and identify cases requiring medical necessity review. Recognize potentially cosmetic or investigational procedures for further review. Maintain compliance with corporate standards for accuracy, professionalism, and productivity. Respond to voicemails and emails within one business day and complete assigned administrative tasks promptly. About You High school diploma required; associate degree in a related field preferred. At least 3 years of customer service experience within the health insurance or healthcare industry. Strong knowledge of medical terminology, managed care systems, ICD-10, and CPT codes. Proficient in navigating and entering data into multiple computer systems. Excellent communication, organizational, and problem-solving skills. Highly detail-oriented with the ability to adapt to change and manage competing priorities. This is a contracted, remote position available to candidates residing in Pennsylvania, New Jersey, or Delaware. Offering $23.00 per hour with remote flexibility, the role offers a collaborative environment with opportunities to work alongside industry professionals. Apply today with your Word resume to join a mission-driven healthcare organization focused on service and quality! Beacon Hill is an equal opportunity employer and individuals with disabilities and / or protected veterans are encouraged to apply. California residents : Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. If you would like to complete our voluntary self-identification form, please click here or copy and paste the following link into an open window in your browser : https : / / jobs.beaconhillstaffing.com / eeoc / Completion of this form is voluntary and will not affect your opportunity for employment, or the terms or conditions of your employment. This form will be used for reporting purposes only and will be kept separate from all other records. Company Profile : Founded by industry leaders to set a new standard in search, career placement and flexible staffing, we deliver coordinated staffing solutions with unparalleled service, a commitment to project completion and success and a passion for innovation, creativity and continuous improvement. Our niche brands offer a complete suite of staffing services to emerging growth companies and the Fortune 500 across market sectors, career specialties / disciplines and industries. Over time, office locations, specialty practice areas and service offerings will be added to address ever changing constituent needs. Learn more about Beacon Hill and our specialty divisions, Beacon Hill Associates, Beacon Hill Financial, Beacon Hill HR, Beacon Hill Legal, Beacon Hill Life Sciences and Beacon Hill Technologies by visiting www.bhsg.com. Benefits Information : Beacon Hill offers a robust benefit package including, but not limited to, medical, dental, vision, and federal and state leave programs as required by applicable agency regulations to those that meet eligibility. Upon successfully being hired, details will be provided related to our benefit offerings. We look forward to working with you! Beacon Hill. Employing the Future (TM)