Precertification Specialist-Surgical Services Admin-FT-Daus

How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives.

Work Shift

Day (United States of America)

Job Summary:

The Pre-Authorization Specialist functions under the direction of the Business Manager. Provides outstanding customer service to customers in a fast-paced busy environment. Drive volumes and increase revenue by obtaining Pre-Authorization for Cobb Surgical Services in a timely Manner. Observing Quality and Productivity standards and other Key Performance Indicators. Responsible for performing a wide variety of clerical procedures that requires independent judgment, ingenuity, and initiative in the utilization of computers and other equipment. Knows the existing lines of communication and authority, handles communications properly and is dependable and cooperative. Works with staff and understands appropriate scheduling and authorization process, willing to learn procedures/patient preps. Assist Scheduling and physician's office staff with authorization issues in a timely manner. Communicate any authorization issues with the provider within 24 hours of the patients' appointment. Make all efforts to avoid Denials, assist with Denials, claim edits, and reconsiderations when needed. Support Revenue cycle. Must be flexible with work hours to meet department needs.

Core Responsibilities and Essential Functions:

Performs other duties as assigned Complies with all Wellstar Health System policies, standards of work, and code of conduct.

Required Minimum Education:

• GED Other or High School Diploma Other

Required Minimum License(s) and Certification(s):

All certifications are required upon hire unless otherwise stated.

• CPC - Cert Prof Coder-Preferred or CCS - Cert Coding Spec-Preferred or RHIA - Reg Health Information Admin-Preferred or RHIT - Reg Health Information Tech-Preferred

Additional License(s) and Certification(s):

Required Minimum Experience:

Minimum 2 years experience in medical practice or hospital billing/coding w/Bachelor's degree Preferred or Minimum 2 years experience in medical practice or hospital billing/coding w/Associate's degree Preferred or Minimum 5 years experience in insurance /benefits Preferred or

Required Minimum Skills:

Strong customer service skills, communication skills, and organizational skills. Basic typing and data entry experience Experience in computer usage and Medical Terminology preferred The individual must be able to communicate and understand verbal and written English language and display a positive attitude (see Wellstar's "Standards of Gold" and Values") This position requires a high level of attention to detail and a low error rate, as the consequences of even a minor mistake can be significant for patients and providers. In addition, this position requires regular, reliable attendance. Medical terminology including coding needed (CPT, ICD, and HCPCS) knowledge of insurance filling and requirements High EPIC and 3M experience preferred High

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