Job Application for PreCert Specialist - Full-Time - Germantown, TN at West Cancer Center

New

Job Title: PreCert Specialist

About Us

West Cancer Center is a comprehensive, patient-centered cancer care and research institution committed to compassionate care, innovation, and clinical excellence. Our multidisciplinary teams deliver integrated care tailored to the needs of each individual and their loved ones.

Position Overview

The PreCert Specialist plays a critical role as the front-line defense ensuring that patients have the required precertification for procedures, drugs, and radiology services. This position is also responsible for entering patient information into the system. The PreCert Specialist serves as a key resource for patients, providers, and staff by navigating insurance requirements, obtaining authorizations, and ensuring accurate documentation.

Key Responsibilities

Verify demographic and insurance information including co-pays, deductibles, stop losses, guarantors, subscribers, and medical policy requirements
Update demographic and insurance records in a timely and accurate manner
Obtain and review physician orders for medical necessity and coverage requirements
Research insurance coverage criteria using payer policies, medical literature, and compendiums
Generate and review computer-based appointment reports
Communicate proactively with medical teams to ensure criteria are met for authorization
Obtain and review authorizations to ensure appropriate payment on the backend
Review self-pay patients, confirm status, and coordinate with patient assistance programs if applicable
Support appeals and peer-to-peer requests for precertification denials
Assist medical teams with cases returned from the office site team to resolve issues
Maintain compliance with policies, procedures, and performance standards
Other duties as assigned

Qualifications

Education & Experience

Required:

High school diploma or equivalent
Minimum three years’ experience in healthcare insurance or medical clinic, with emphasis on obtaining precerts/predeterminations
Experience reviewing medical necessity, payer policies, and medical coverage criteria
Experience in high-volume medical clinic or healthcare environment

Preferred:

Experience with chemotherapy and radiology precertifications

Skills & Abilities

Strong knowledge of managed care, medical terminology, precert processes, and insurance claims processing
Familiarity with coding systems (ICD-9, ICD-10, CPT, HCPCS) for chemotherapy precertification requests
Proficiency with Microsoft Office applications and multiple healthcare systems/websites
Excellent navigational skills using intranet and internet resources
Strong organizational skills with ability to handle high patient volumes
Excellent problem-solving skills and high attention to detail
Strong written and verbal communication abilities
Knowledge of clinical coverage guidelines and medical policies

Why West Cancer Center is a Great Place to Work

Meaningful Impact: Play a direct role in supporting patients through one of the most challenging times of their lives.
Collaborative Culture: Work alongside a multidisciplinary team of dedicated professionals committed to improving cancer care.
Professional Development: Benefit from ongoing training, educational resources, and growth opportunities.
Mission-Driven Environment: Be part of an organization guided by compassion, integrity, and innovation.

No nights, weekends, or holidays. Comprehensive benefits package.

Join Us

If you’re a detail-oriented professional with a strong knowledge of healthcare insurance and precertification processes, we invite you to apply and join our mission-driven team at West Cancer Center.

Create a Job Alert

Interested in building your career at West Cancer Center? Get future opportunities sent straight to your email.

First Name

Last Name

Country

Phone

Location (City)

Resume/CV*

Accepted file types: pdf, doc, docx, txt, rtf

Cover Letter

Accepted file types: pdf, doc, docx, txt, rtf

School

Select...

Degree

Select...

Discipline

Select...

Start date month

Select...

Start date year

End date month

Select...

End date year

LinkedIn Profile

Website

Interested in Working, Full-time, Part-time, Supplemental

How did you hear about this job?

If referred, please list name of the associate that referred you

To help us align expectations early in the process, please share your target salary range in USD. We understand that this may be negotiable, but having a range helps us use your time efficiently.

List active, relevant certifications and expiration dates

List active, relevant licensure, expiration dates and state if applicable

List any current memberships or volunteer work

Have you ever worked for West Clinic/West Cancer Center or its affiliates in the past?

Select...

If you have worked for West Clinic/West Cancer Center or its affiliates in the past, please list positions(s) and any other name or alias used while employed.

Do you have any relatives or household members employed by West Cancer Center? If so, please indicate name, job title, and location. Do not include any information or identification of marital status.

Have you ever been terminated or resigned in lieu of termination?

Select...

If you have ever been terminated or resigned in lieu of termination , please explain:

Are you legally authorized to work in the United States?

Select...

How many years’ experience do you have completing pre-determinations/pre-certifications of insurance?

May we contact your current employer?

Select...

Have you ever been convicted, pled no contest, or pled guilty to a felony or do you currently have a pending charge? Type YES or NO. If yes, please explain:

Have you ever been convicted, pled no contest, or pled guilty to ANY misdemeanor to include involving fraud, writing bad checks, theft, DUI, or drugs? DO NOT include juvenile cases or cases sealed or expunged by a court. Do not assume charges have been removed. Type YES or NO. If yes, please explain:

Have you currently or have you previously been excluded, suspended, or otherwise been ineligible for participation in federal programs, or do you have a controlling interest in an entity that has been so excluded or suspended? Have you ever been sanctioned, disciplined, debarred, and/or excluded by a duly authorized regulatory agency, or are there current restrictions/limits on your license or certification? Type YES or NO. If yes, please explain:

Have you ever served as an expert witness or consultant in healthcare malpractice cases? Type YES or NO. If yes, please explain:

Are you presently under an employment contract?

Select...

If you are presently under an employment contract, when does it expire?

Please provide 5 professional references to include their name, phone number, and email address.

Please list any other names used (maiden, alias, nickname) or type NONE.

I understand that West Clinic/West Cancer Center does not respond to application status inquires until I have been selected for a position or the position is filled by another candidate? *

Yes

I hereby authorize West Clinic/West Cancer Center to conduct work history, education, personal reference, or police record inquires to determine my acceptability for employment. I authorize West Clinic/West Cancer Center and its agents to procure a consume report and/or investigate consumer report about my background, character or reputation, including, but not limited to information as to my employment, education, consumer credit history (if appropriate for certain job descriptions), driving record, social security number verification, criminal record, and/or public record history. I authorize all persons to fully disclose information relevant to this investigation. I release from liability all persons, companies, and government or other agencies disclosing such information. I further authorize that a photocopy of this authorization may be considered an original. *

Yes

I understand that by submitting this application, I acknowledge and warrant the truthfulness of the information provided in this document. *

Yes

Voluntary Self-Identification

For government reporting purposes, we ask candidates to respond to the below self-identification survey. Completion of the form is entirely voluntary. Whatever your decision, it will not be considered in the hiring process or thereafter. Any information that you do provide will be recorded and maintained in a confidential file.

As set forth in West Cancer Center’s Equal Employment Opportunity policy, we do not discriminate on the basis of any protected group status under any applicable law.

Gender

Select...

Are you Hispanic/Latino?

Select...

Race & Ethnicity Definitions

If you believe you belong to any of the categories of protected veterans listed below, please indicate by making the appropriate selection. As a government contractor subject to the Vietnam Era Veterans Readjustment Assistance Act (VEVRAA), we request this information in order to measure the effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA. Classification of protected categories is as follows:

A "disabled veteran" is one of the following: a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service-connected disability.

A "recently separated veteran" means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service.

An "active duty wartime or campaign badge veteran" means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.

An "Armed forces service medal veteran" means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.

Veteran Status

Select...

PreCert Specialist - Full-Time - Germantown, TN

Apply for this job

Voluntary Self-Identification