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Physician Practice Referral/Prior Authorization Specialist

SUMMARY OF MAJOR FUNCTION:
This position will complete referrals and pre-certifications generated from WCGH's physician practices based on the given insurance.
This position will work closely with all physician practices, fiscal services, radiology and other hospital departments as necessary.
This position will call patients and verify insurance information as needed.
This position will review all admissions for pre-certification; this includes all scheduled CT scans, nuclear medicine exams, procedures, surgeries and emergency admissions.
REQUIREMENTS/QUALIFICATIONS:
High school diploma.
3+ years of experience in hospital billing and/or physician practice setting, preferred.
In depth knowledge of referral and pre-certification process/requirements for different insurance companies, preferred.
Excellent interpersonal, teamwork and communication skills a must.
The ability to work in a fast paced and time sensitive environment.
In depth knowledge of hospital computer systems, preferred






















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