WMG Precertification Specialist l
Company: WellStar Health System, Inc.
Location: Avondale Estates
Posted on: January 27, 2023
A WMG Pre-certification Specialist I is responsible for obtaining
pre-certification/authorization for outpatient diagnostic
procedures for practice and HOD visits and ensuring referrals are
completed timely. The WMG Pre-certification Specialist I position
reports directly to the WMG Central Precertification Manager.
The WMG Pre-certification Specialist I function under the direction
of the Manager of Centralized Precertification. Provides
outstanding customer service to their dedicated physician practice.
This position supports practice volumes and increasing revenues by
obtaining Pre-Authorization for outpatient testing, outpatient
diagnostic and medications in a timely manner while maintaining the
required 3 day out ahead of the practice's schedule. Consistent
review of payer authorization policies to ensure all procedures are
authorized in a timely manner. Utilize various departmental tools
and appropriate reports to identify and trend any on-going issues
with payers and physician practice processes resulting in fatal
denials. This position works with physicians, nurses, clinic
managers and financial advocates to resolve issues that arise
during the prior authorizations process. This position may also
support Pre-Registration including preparing patient estimates.
Maintain established productivity benchmarks and meets goals in a
fast-paced environment. Other duties as assigned.
Impact of this role in the organization:
The WMG Pre-certification Specialist I impact to the organization
improves Patient Experience and operational workflow in respect to
Patient Access to services within WMG practices.
Keywords: WellStar Health System, Inc., Atlanta , WMG Precertification Specialist l, Other , Avondale Estates, Georgia
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