Authorization Clinician - Samaritan Hospital - FT Days
About The Position
Position Summary: The Authorization Clinician for outpatient is responsible for the tracking and review of those cases requiring telephonic case management. Tracking is accomplished via computer. Pre-authorization and case management is done with reviewers at the Managed Care Organization that is responsible for approving a client's treatment. The Authorization Clinician for inpatient is responsible for managing the authorization process for prospective patients and insurers. This involves determining an appropriate level of care based on established admission criteria; once those determinations are made, presenting the clinical cases to insurers and managed care companies to secure authorizations for admission to treatment at the St. Peters inpatient rehabs. Also responsible for: welcoming and registering incoming patients to rehab, screening prospective clients for placement into the numerous St. Peter's addictions programs & investigating delinquent accounts and securing payment for denials; The Authorization Clinician is instrumental in answering inquiries from referents and persons in the community seeking treatment for substance abuse, providing guidance to appropriate levels of care in the SPARC continuum or other agencies in the community.
Requirements
- Bachelor’s degree or Associates degree with a QHP is required. Master's degree in a related field and QHP is preferred.
- One to three years experience in the Behavioral Services field a prerequisite.
- Experience with insurance/managed care organizations a plus.
- Familiarity with PC basics necessary with the ability to learn new programs.
- Strong writing and communication skills are required, as well as knowledge of working with community agencies and managed care representatives.
- Experience working with a diverse population and a strong understanding of multicultural issues is preferred
Nice To Haves
- Master's degree in a related field and QHP is preferred.
- Experience with insurance/managed care organizations a plus.
- Experience working with a diverse population and a strong understanding of multicultural issues is preferred
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
