Pre-Certification Spec I at Nemours

Posted in General Business 19 days ago.

This job brought to you by eQuest

Type: Full-Time
Location: Jacksonville, Florida





Job Description:

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.

Primary Functions


  • 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.

Performance Skills


  • 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.

Job Requirements


  • High School Diploma required

  • CPC Preferred

  • CPT/ICD-10

  • Medical Office

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.