Develops and implements outpatient pre/re-certification and pre-registration processes for commercial insurance coverage of outpatient treatment services and outpatient Medicaid prior authorization processes. Focusing on outpatient Radiology and Surgical scheduled procedures, obtains schedules proactively from the service areas, verifies insurance coverage, completes pre-registration in HIS system, and obtains pre-certifications as required by payer prior to the date of service. Refers self-pay patients to Financial Counseling prior to date of service.
Minimum Education: High school diploma or GED, however, additional clerical/business training or licensure/certification such as LPN or Radiology Tech is preferred for pre-registration/pre-certification position at GFHC.
Minimum Experience: Will consider new clerical/business school graduates, but would prefer 2-3 years professional experience in registration, billing, radiology, or physician health plan office.