The Pre-certification Specialist is responsible for obtaining surgery pre-certifications and coordinating medical information with insurance companies. They must also maintain accurate patient records and address inquiries regarding surgery authorization status.
The coder is responsible for accurately assigning ICD-10 and CPT codes to hospital dictation and charge slips while managing patient demographic data. They also handle charge posting, resolve coding issues within the Athena system, and ensure compliance with insurance and legislative guidelines.
The RCM Lead supports daily front-end revenue cycle operations, including patient access, insurance verification, and financial clearance. They also provide workflow guidance, staff training, and monitor productivity to ensure accurate and timely service.
The specialist is responsible for managing the revenue cycle by processing insurance claims, resolving denials, and ensuring accurate billing. They also collaborate with various departments to address claim errors and provide professional customer service to patients and insurance payers.
