Piedmont Healthcare Atlanta , GA 30301
Contacts insurance companies and other third party payers to determine pre-certification, pre-authorization and/or medical necessity requirements for complex outpatient hospital services, and specialized procedures (i.e. Recurring Visits, Surgeries, IR). Obtains pre-certification or pre-authorization prior to the scheduled complex service being performed.
Liaisons with physicians and physician office staff when needed to obtain additional demographic, insurance or clinical information. Notify payers of admittance if required.
MINIMUM EDUCATION REQUIRED:
High school diploma or GED
MINIMUM EXPERIENCE REQUIRED:
Three (3) yrs exp in Rev Cycle or related exp in healthcare, with one of those years working specifically within Healthcare Revenue Cycle.
MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW:
Four (4) years of previous related healthcare Revenue Cycle experience preferred. A Bachelor's degree from a recognized college or university preferred.
Certification with Healthcare Financial Management Association, or Certified Revenue Cycle Representative preferred. Prior Epic experience preferred.
Clinical experience (i.e. medical assistant, surgical tech) or completion of medical coder training program preferred.