Precertification Rep
On-siteWest Allis, Wisconsin, United States
Job Summary
Initiate precertification and authorizations for inpatient and outpatient services via online portals, phone, or written documentation for day surgeries, radiology, and therapies. Contact insurance companies, primary care physicians, and patient families to secure referrals for out-of-network cases and enter referral data into Epic accurately. Pre-register patients by calling families or using department protocol to ensure accounts flow through the billing cycle without errors. Complete the Ambulatory Clinic deemed/communication tool, identify consent signatures, and refer patients to financial counselors per CHW guidelines. Educate patients and guardians on the managed care process while utilizing the Language Interpretation system for non-English speakers. Manage assigned work queues to ensure accuracy and completion per department guidelines.
Required Qualifications
- High School graduate or Certificate of General Educational Development (GED) or High School Equivalency Diploma (HSED)
- 2+ years of experience in registration, scheduling or administrative support experience in a healthcare setting or a business environment
- 1+ years experience as a Financial Verification Rep
- Experience with insurance referral and authorization processing
- Epic experience
- Prior experience working in Windows environment
- Excellent organizational, analytical, and prioritizing skills necessary to work in a fast-paced environment with multiple tasks done simultaneously
- Excellent communication and interpersonal skills necessary to gather and share information with families, and team members in a courteous, professional and confidential manner
- Ability to maintain positive communication skills during stressful situations
- Analytical ability to determine the anticipated patient liability and ascertain need for financial counseling
Desired Qualifications
- Preferred Epic experience preferred
- Preferred Prior experience working in Windows environment
Hiring someone like this?
Get your role in front of qualified candidates on Sorce.