What are the responsibilities and job description for the Prior Authorization Specialist position at Cherry County Hospital?
This position is responsible for obtaining pre-certifications and pre-authorizations for procedures and medications, scheduling appointments for outpatient testing with other providers, and coordinates patient appointments/orders.
ESSENTIAL DUTIES: Responsibilities include but are not limited to the following-
1. Contact insurance carriers to verify patient's insurance eligibility, benefits and requirements.
2. Request, track, and obtain pre-authorization from insurance carriers within time allotted for medical procedures and services.
3. Request, follow up and secure prior-authorizations prior to services being performed.
4. Demonstrate and apply knowledge of medical terminology, high proficiency of general medical office procedures including HIPAA regulations.
5. Communicate any insurance changes or trends among departments.
6. Maintains a level of productivity suitable for the department.
7. Clearly document al communications and contacts with providers and personnel in standardized documentation requirements, including proper format.
8. other duties as assigned.
OTHER JOB DUTIES: Notify department heads as to the needs of any additional staffing or equipment. Occasional filing or record retrieval. Cooperates and works well with staff, public, and physicians. Knowledgeable of, and commuted to practicing Corporate Compliance policies and procedures. Knowledgeable of HIPAA regulations and ensures the confidentiality of patient's medical, personal, and financial records is maintained. Complies with Cherry County Hospital personnel policies. Performs other duties as assigned by department head.
QUALIFICATIONS:
-High School Diploma required
-Prior customer service experience in a medical setting, preferred.
-Knowledge of medical terminology, preferred
-Prior experience and knowledge in the use of software packages such as Microsoft Excel, Word, and Windows.
Cherry County Hospital is an Equal Opportunity Employer.
Job Type: Full-time
Pay: From $17.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Ability to commute/relocate:
- Valentine, NE 69201: Reliably commute or planning to relocate before starting work (Required)
Experience:
- Customer Service: 1 year (Preferred)
Work Location: One location
Salary : $17
