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Precertification Specialist WMCG at Wellstar Health System - ApplyBlast

Precertification Specialist WMCG

Wellstar Health System

5 months ago

3.1 on Glassdoor

Onsite

Full Time

Junior

0 applicants

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About this role

The Outpatient Infusion Pre-Authorization Specialist at Wellstar obtains necessary authorizations for infusion procedures in a fast-paced healthcare environment to drive revenue and prevent claim denials. This role requires managing communication between patients, physicians, and insurance carriers while adhering to strict quality productivity standards and Medicare guidelines. The position involves handling complex clerical procedures, verifying insurance eligibility, and ensuring timely data entry within the Epic system.

Responsibilities

Obtain pre-authorization numbers for outpatient infusion procedures
Verify insurance eligibility and benefits for scheduled patients
Communicate authorization issues with patients and providers within 24 hours
Maintain accurate records and notes in the Epic system
Assist with claim edits and reconsiderations to prevent denials

Skills

Qualifications

High School DiplomaGED

About Wellstar Health System

wellstar.org

Headquarters

Marietta, Georgia, United States

Company Size

10001+ employees

Founded

1993

View Profile

Wellstar Health System is the largest and most integrated healthcare system in Georgia, operating hospitals, affiliated medical groups, urgent care centers and tailored health plans across the state. It offers comprehensive care in virtually all medical specialties — including primary care, heart care, cancer treatment, neurological services and women's health — through inpatient, outpatient and virtual channels. Nationally and locally recognized for high-quality, patient-centered care and exceptional caregivers, Wellstar emphasizes coordinated, accessible services and easy ways to find and schedule care.