WellStar Health Systems Precertification/Prior Authorizaion Specialist in Marietta, Georgia

Job Title:

Precertification/Prior Authorizaion Specialist

Job ID:

ES-1111380

City:

Marietta, GA

Facility:

Enterprise Support

Employment Type:

Regular

Full/Part Time:

Full-Time

Shift:

Days

Department:

Medical Imaging Schedulers

Description:

WellStar Health System, the largest health system in Georgia, is known nationally for its innovative care models, focused on improving quality and access to healthcare. Staying ahead of the curve in technology has enabled WellStar to be leaders in both the diagnosis and treatment of an extensive array of health conditions. Serving a diverse population, WellStar consistently looks at total patient wellness and works to ensure that all systems support that focus. WellStar is recognized nationally as an Employer of Choice and is featured on FORTUNE 100 Best Companies to Work For® list and Work Mother Magazine’s Best Companies list.

Specialists and primary care providers work in a multi-disciplinary environment with 20,000 team members throughout our 11 hospitals, 225 medical office locations, outpatient centers, health parks, a pediatric center, nursing centers, hospice, homecare. By working through a patient-centered model of care, WellStar places enormous value on quality and safety with many accolades to support our work.

The Medical Imaging Pre-Certification Specialist functions under the direction of the PreAuthorization Supervisor/ Manager

and Diagnostic Outreach VP. Provides outstanding customer service to customers in a fast paced busy call enter environment.

Drive volumes and increase revenue by obtaining Pre-Authorization for Outpatient Medical Imaging 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, patient and

physician’s office staff with authorization issues in a timely manner. Communicate any authorization issues with the

patient and provider within 24 hours of the patients’ appointment. Make all efforts to avoid Denials, assist with

Denials, reconsiderations when needed. Support Revenue cycle. Must be flexible with work hours to meet

department needs.

Required Minimum Education : High School graduate or equivalent.

Required Minimum Experience :

Worked in healthcare setting performing prior authorizations. Two years experience in insurance/precertification

preferred, minimum of one year experience required.

Required Minimum Skills : Good communication skills and organizational skills. 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.

Why work for WellStar?

  • Concierge Services: Employees use the free concierge service to take care of day-to-day errands such as dry cleaning pick-up, oil changes, grocery shopping, assist in researching and arranging travel plans, and helps with planning family events.

  • Health Coverage: Competitive healthcare premiums and coverage for employees and dependents. Bariatric surgeries performed within the WellStar network are covered 100%. Employees have access to our on-site pharmacy for prescriptions at discounted rates and the use of payroll deduction.

  • Work-Life Balance Programs: WellStar’s commitment to your work-life balance is shown by offering flexible schedules, telecommuting, job sharing, and flex time. We offer on-site child care, backup care and elder assistance care.

  • Wellness Programs: Employees can stay active by using our on-site fitness center with discounted fitness classes. We provide a weekly farmers basket program that lets employees buy fresh local produce at an average price of $16.00 or less a basket.

  • Recognition Programs: Employees receive recognition through several WellStar programs; The Winners of WellStar (WOW) program lets employees recognize and reward their peers with awards and gifts.

  • Parental Benefits: Full-time employees receive 120 hours of paid maternity or paternity leave; benefit eligible part-time employees receive 60 hours for the birth or adoption of a child. Adoptive parents can receive $10,000 in adoption benefits per child, with a total lifetime benefit of $20,000.

  • Additional Benefits: Education and tuition assistance programs, employee/employer contribution pension plans, and on-site dining options for convenience.

Come see why our employees love their career at WellStar and enjoy work-life balance and the opportunity for advancement from within.

Thank you for your interest in WellStar. We are an equal opportunity employer.