Hancock Regional Hospital

Pre-Certification Clerk

Job ID
Patient Access Services
Position Type
Full Time


1. Answer calls from physician offices, hospitals and patients using exemplary customer service skills. 2. Accurately enter required information (non-clinical and structured clinical data) into computer database. 3. Review structured clinical data matching it against specified medical terms and diagnoses or procedure codes (without the need for interpretation) and follow established procedures for authorizing request or referring request for further review. 4. Call back providers with precertification numbers as needed and file completed precertification requests as per established procedures. 5. Validate benefit coverage per established procedures. 6. Maintain patient confidentiality as defined by state, federal and company regulations. 7. Establish effective rapport with support service staff, customers, clients, patients, families and physicians and actively support departmental strategic plans and ensure successful implementation. 8. Maintain cooperative working relationships with all UM departments and providers.


Associate is capable of delivering required care/service appropriate to patients/customers. 2. Initiates pre-certification process on all required outpatient hospital services and initiates rescheduling appointments as needed. 3. Serves as a resource for inpatient certification as needed. 4. Supports patient financial services with appeals and retro authorizations as needed. 5. Collects and distributes appropriate registration and certification documents to pertinent hospital departments. 6. Keys all required certification information into the hospital Meditech information system. 7. Displays and maintains behavior which promotes good guest relations to patients, visitors, physicians, and co-workers. 8. Initiates corrections of registration information upon review of admissions and services requiring pre-certification. 9. Demonstrates ability to embrace and adapt to change and regularly initiates ideas to improve the efficiency and processes of the department. 10. Performs similar or related duties as assigned.


RN or LPN graduate of accredited nursing program. Mandatory Continuing Education: Customer Service, Fire and Safety, Corporate Compliance (including Confidentiality), Infection Control, and education required by regulatory, accreditation bodies, scope of practice, and/or Hancock Regional Hospital. Previous experience in Utilization Management preferred.
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