Job Title: Pre-Certification Specialist
 

Job Overview:
Contemporary Staffing Solutions is seeking a Pre-Certification Specialist to join our client to support the coordination and review of pre-authorization requests for healthcare services. This fully remote contract position is open to candidates located within one hour of Philadelphia in PA, NJ, or DE. The Pre-Certification Specialist will ensure requests are processed promptly and accurately, working closely with healthcare providers and members to confirm eligibility, collect clinical details, and maintain compliance with established standards. This role is ideal for someone who thrives in a fast-paced call center environment and enjoys balancing accuracy, communication, and customer service in the healthcare space.
 

Compensation:
$23.00/hour
 

Work Schedule:
Monday–Friday, 8:00 AM – 5:00 PM (37.5-hour work week)
 

Key Responsibilities of the Pre-Certification Specialist:
• Respond to inbound calls and electronic requests from members and healthcare providers regarding pre-certification and authorization of medical services.
• Verify member eligibility, provider participation, and service details using multiple systems and databases.
• Collect and document clinical data, including diagnosis and procedure codes, ensuring all necessary information is recorded accurately.
• Approve or escalate requests according to departmental policies and medical necessity criteria.
• Maintain compliance with HIPAA, state, and federal regulations while meeting quality and productivity standards.
• Communicate professionally and efficiently to resolve inquiries and follow up on outstanding requests within required timeframes.
 

Qualifications and Skills for the Pre-Certification Specialist:
• High school diploma required; an associate degree in a healthcare-related field is preferred.
• At least three years of customer service experience within health insurance, managed care, or healthcare administration.
• Strong technical proficiency with Microsoft Office and comfort navigating multiple software systems simultaneously.
• Knowledge of medical terminology, CPT/ICD-10 codes, and healthcare authorization processes.
• Previous experience in a high-volume call center or medical office setting.
• Excellent attention to detail, communication, and organizational skills with the ability to adapt to workflow changes.
 

Why Join Us?
This opportunity allows you to build hands-on experience in healthcare operations while supporting meaningful work that impacts patient care. You’ll collaborate with skilled professionals, expand your industry knowledge, and gain valuable exposure to managed care systems—all within a supportive and structured team environment.
 

About Us:
Contemporary Staffing Solutions (CSS) is a trusted leader in providing contract, temporary, temp-to-hire, and direct hire staffing solutions. With decades of experience, we’ve grown from a staffing agency to a nationwide provider of workforce management solutions. Our niche recruitment expertise spans Accounting & Finance, Call Center & Office Support, Human Resources, Sales & Marketing, and Information Technology. Explore more about CSS and how we connect great talent with exceptional opportunities by visiting www.ContemporaryStaffing.com.