As one of the nation’s leading pediatric health care systems, Nemours is committed to providing all children with their best chance to grow up healthy. We offer integrated, family-centered care to more than 300,000 children each year in our pediatric hospitals, specialty clinics and primary care practices in Delaware, Florida, Maryland, New Jersey and Pennsylvania. Nemours strives to ensure a healthier tomorrow for all children – even those who may never enter our doors – through our world-changing research, education and advocacy efforts. At Nemours, our Associates help us deliver on the promise we make to every family we have the privilege of serving: to treat their child as if they were our own.
Nemours is seeking a Pre-Certification Spec I , FULL-TIME to join our team in Jacksonville, Florida. At Nemours, each Associate plays a vital role in supporting the delivery of world-class pediatric care to the children we serve.
Obtain precertification and enter into Epic for scheduled and urgent surgical procedures, ancillary services, hospital admissions and other hospital based services. Create Financial Advocate appointments and answer patient families questions about insurance benefits and associated out of pocket cost of procedure.
Communicate with assigned clinics in the event precertification is denied or request additional information when necessary.
Notify hospital with precertification information.
Monitor Outlook email, Epic in-basket, voice mail and respond in a timely manner.
Provide necessary coverage during other team members absence.
All other duties as assigned by supervisor or manager.
Use professional language and appropriate grammar at all times in verbal or written communication.
Ability to work with minimal supervision, possess critical thinking skills and be solution oriented.
Embraces cultural diversity in the workplace.
Govern self by personal standards of integrity/ethics
Organize and prioritize responsibilities in order to meet deadlines.
High School Diploma required
Our dedication to professionals who are dedicated to children frequently earns Nemours a spot on the list of top workplaces in the communities we serve. Our Associates enjoy comprehensive benefits, including our unique “Bridge to a Healthy Future” pediatric health plan, an integrated wellness program, opportunities for professional growth, and much more. As an equal opportunity employer, Nemours focuses on the best-qualified applicants for our openings.
Nemours is committed to improving the health of children. As a non-profit children’s health organization, we consider the health of every child to be a sacred trust. Through family-centered care in our children’s hospitals and clinics in Delaware, New Jersey, Pennsylvania and Florida, as well as world-changing research, education and advocacy, Nemours fulfills the promise of a healthier tomorrow for all children — even those who may never enter our doors. Nemours began more than 70 years ago with the vision of Alfred I. duPont to improve the lives of children and to do whatever it takes to prevent and treat even the most disabling childhood conditions. Today, through our children’s hospitals and health system, we directly care for 250,000 children annually in Delaware Valley and Florida, including families who travel from across the country and world to see our specialists — treating every child as we would our own. We also reach beyond the walls of our hospitals and clinics to be a voice for children on a national and international level, and to lead the way in prevention, intervention, education, and research. Nemours is growing to better serve the children and families in our ca...re. We have 1.1 million square feet of space currently devoted to providing children’s healthcare or under construction, all designed with significant input and advice from our patients and families.