- Supports and practices the mission and philosophy of Billings Clinic and Radiology Department.
- Coordinates pre-certification process with provider offices to ensure target goal of 98% of pre-scheduled elective inpatient and outpatient procedures are pre-authorized.
- Documents and maintains patient specific pre-certification/authorization data within the required information systems. Compiles, documents, and tracks monthly pre-certifications using established procedures.
- Keeps undated list. Ensures correct patient status when pre-certifying.
- Reviews CPT-4 codes of required pre-certification and/or authorizations; ensuring Passport pre-certification process is also met.
- Reports denials and/or delays in the pre-certification process to physicians/other health care providers and the patient. May provide information to the patient on the appropriate appeal procedures for denials.
- Responsible for coordinating resolution of varied problem situations and performing necessary investigation and research to resolve pre-certification problems.
- Reports non-compliance issues and/or needs for program expansion to Manager.
- Works closely with Medical Staff, Payer Relations and Patient Financial Services to coordinate needed pre-certification authorizations for in-network services.
- Tracks and verifies receipt of pre-certification authorizations has been received either verbally or written. Communicates status to providers and patients as needed.
- Develops and maintains collaborative working relationships with payers and health care providers.
- Reviews, updates and standardizes forms and processes as needed
- Participates in interdepartmental meetings to coordinate efforts, work through processes, and foster communication.
- Develops and maintains reference manuals that outline the individual payer requirements as it relates to pre-certification and pre-authorization needs.
- Assists patients/family members with status of pre-certification or re-certification information.
- Identifies needs and sets goals for own growth and development; meets all mandatory system/department requirements. Maintains knowledge of current trends and developments as it relates to the pre-certification process.
- Maintains competency in all organizational, departmental and outside agency environmental, employee or patient safety standards relevant to job performance.
- Performs other duties as assigned or needed to meet the needs of the department/organization.
- High school graduate or equivalent
- One (1) year of medical insurance claims experience through patient accounts billing or claims adjudication
-
Radiology Pre-Certification Specialist
6 days ago
Billings Clinic Billings, United StatesYoull want to join Billings Clinic for our outstanding quality of care, exciting environment, interesting cases from a vast geography, advanced technology and educational opportunities. We are in the top 1% of hospitals internationally for receiving Magnet Recognition consecutive ...
-
Senior Pre Service Specialist Remote
2 days ago
Providence St. Joseph Health Billings, United StatesProvidence St. Joseph Health · Senior Pre Service Specialist *Remote* · Billings , · Montana · Apply Now · Senior Pre Service Specialist - 100% Remote - We welcome residents in our footprint states, AK, CA, OR, WA, TX, or MT · Under the direction of the Pre-Service Superviso ...
-
Senior Pre Service Specialist Remote
2 weeks ago
Providence Health & Service Billings, United States· Providence is calling a Senior Pre-Service Specialist who will work remotely within · our footprint states, AK, CA, OR, WA, TX, NM, or MT. · Under the direction of the Pre-Service Supervisor/Manager/Director, the Senior Pre-Service Specialist has a clear understanding and kn ...
-
Senior Pre Service Specialist Remote
2 weeks ago
Providence Health & Service Billings, United StatesProvidence is calling a Senior Pre-Service Specialist who will work remotely within our footprint states, AK, CA, OR, WA, TX, NM, or MT.Under the direction of the Pre-Service Supervisor/Manager/Director, the Senior Pre-Service Specialist has a clear understanding and knowledge of ...
-
Fiber Optic Technician
2 weeks ago
Ziply Fiber Billings, United StatesPosition Title: Fiber Optic Technician · Non-Union · $20 to $26 Hourly DOE · Comprehensive health benefits include: medical, dental, vision, 401k, flexible spending account, paid sick leave and paid time off, quarterly performance bonus, training, career growth and education ...
-
NeuroPsych Sales Specialist
1 week ago
Teva Pharmaceutical Industries Billings, United StatesWho we are · Together, we're on a mission to make good health more affordable and accessible, to help millions around the world enjoy healthier lives. It's a mission that bonds our people across nearly 60 countries and a rich, diverse variety of nationalities and backgrounds. Wor ...
-
NeuroPsych Sales Specialist
1 week ago
Teva Pharmaceuticals Billings, United StatesNeuroPsych Sales Specialist - Billings, MT · Date: May 8, 2024 · Location: · Billings, United States, Montana, 00000 · Company: Teva Pharmaceuticals · Job Id: 55857 · Who we are · Together, we're on a mission to make good health more affordable and accessible, to help millions ar ...
-
Intermountain Healthcare Billings, United StatesJob Description: · Responsible for registering patients in multiple service lines all necessary demographic, financial, and clinical information from the patient or representative. · Practice details: · As a Patient Access Associate I / Registration Specialist, you need to know h ...
-
Intermountain Healthcare Billings, United StatesJob Description: · Responsible for registering patients in multiple service lines all necessary demographic, financial, and clinical information from the patient or representative. · This is a PT opening. Shifts will vary · As a Patient Access Associate I / Registration Specialis ...
-
IT Field Tech
3 weeks ago
Innova Solutions Billings, MT, United StatesIT Field Tech - Billings/Montana Region · Innova Solutions is seeking an IT Field Tech Support Specialist with great customer service skills, desktop support experience and system administration experience. · This job is onsite in Billings MT and will require regional field sup ...
-
learn to swim manager
1 week ago
City of Billings Billings, United StatesLearn to Swim Manager · $16.00 per hour - One Position Available · Seasonal - Position runs from June 1, 2024 until September 9, 2024 · Work Schedule: 20-40 hours per week, varies daily. Pool is open Monday through Sunday (weather dependent). Half day shifts are available. Fle ...
-
Patient Access Associate PRN
1 week ago
Intermountain Healthcare Billings, MT, United StatesJob Description: · Responsible for registering patients in multiple service lines all necessary demographic, financial, and clinical information from the patient or representative. · Practice Details: · This is a PRN position "As needed" · As a Patient Access Associate I / Regist ...
-
Travel LPN
5 days ago
Leaderstat - Post Acute Billings Metropolitan Area, United StatesJob Description · Leaderstat - Post Acute is seeking a LPN / LVN for a travel job in Billings, Montana. · Job Description & RequirementsSpecialty: LPN / LVN · Discipline: LPN / LVN · Start Date: ASAP · Duration: 13 weeks · 36 hours per week · Shift: 12 hours · Employment Type: Tr ...
-
rn - or
1 week ago
Travel Nurse Across America Billings, MT, United States· Put another $10,000 in your pocket when you take 5 assignments. Up to 15 weeks of vacation. For real. · Apply for more details · We're looking for Operating Room RNs for an immediate travel nurse opening in Billings, MT. The right RN should have 1-2 years recent acute care exp ...
-
IT Field Tech
2 weeks ago
Ascent Services Group Billings, United StatesIT Field Tech - Billings/Montana Region · Innova Solutions is seeking an IT Field Tech Support Specialist with great customer service skills, desktop support experience and system administration experience. This job is onsite in Billings MT and will require regional field ...
-
Travel LPN
5 days ago
Leaderstat - Post Acute Billings, MT, United StatesLeaderstat - Post Acute is seeking a LPN / LVN for a travel job in Billings, Montana. · Job Description & Requirements · Specialty: LPN / LVN · Discipline: LPN / LVN · Start Date: ASAP · Duration: 13 weeks · 36 hours per week · Shift: 12 hours · Employment Type: Travel · Estimate ...
-
SCL Health Billings, United StatesJob Description: · The CV Invasive Specialist performs duties necessary for advanced interventional procedures at a technical and professional level requiring little or no supervision of technical detail. The Specialist performs technical procedures that regularly require indepen ...
-
cdl delivery driver
2 weeks ago
American Welding & Gas Inc. Billings, MT , USA, United StatesAmerican Welding and Gas, Inc. (AWG) has an immediate opportunity for a Delivery Driver in Billings, MT. This position requires a Class A CDL with HazMat, and Air Brake endorsements. · $5000 SIGN ON BONUS · Incentives: · * Competitive Pay · * Collaborative team environment · * Co ...
-
CDL Delivery Driver
1 week ago
American Welding & Gas Inc. Billings, MT, United StatesAmerican Welding and Gas, Inc. ("AWG") has an immediate opportunity for a Delivery Driver in Billings, MT. This position requires a Class A CDL with HazMat, Tanker, and Air Brake endorsements. · Over night 3 days a week · $3500 SIGN ON BONUS · Incentives: · * Competitive Pay · * ...
-
Invasive Cardiovascular EP Technologist Cath Lab
3 weeks ago
SCL Health Billings, United StatesJob Description: · The CV Invasive Specialist performs duties necessary for advanced interventional procedures at a technical and professional level requiring little or no supervision of technical detail. The Specialist performs technical procedures that regularly require indepen ...
Radiology Pre-Certification Specialist - Billings, United States - Billings Clinic
Description
Radiology Pre-Certification Specialist
Billings Clinic (BILLINGS CLINIC HOSPITAL)
req6165
Shift: Day
Employment Status:
Full-Time (.75 or greater)
Hours per Pay Period: 1.00 = 80 hours (Non-Exempt)
Starting Wage:
$
Responsible for the completion of pre-certification, prior authorization and notification for third party and government payers for all pre-scheduled elective inpatient and outpatient examination and procedures requiring preauthorization.
Essential Job Functions
Minimum Qualifications
Education
Experience
