Processing precertification requests in a fully remote capacity, the Pre-Certification Specialist will handle high-volume calls from members and healthcare professionals, verify eligibility, and ensure compliance with corporate guidelines and regulations. Key responsibilities: Manage incoming calls regarding precertification requests from members and healthcare professionals Verify member eligibility and provider participation status using multiple database systems Process precertification requests and enter pertinent data into the appropriate systems Required qualifications: High school diploma required; associate degree in a related field preferred Minimum of three years of customer service experience in the health insurance or health services industry Knowledge of medical terminology and familiarity with ICD9/ICD10 and CPT codes Experience with computerized databases, including Word, Excel, and Mainframe Knowledge of INSINQ is a plus