Authorization Specialist

HealthPartners • Saint Paul, MN

9h

About The Position

Park Nicollet is looking to hire an Authorization Specialist to join our team! Come join us as a Partner for Good and help us make an impact on the care and experience that our patients and their families receive every day. Position Summary: The Authorization Specialist is responsible for creating hospital encounters for surgical services throughout Park Nicollet Ambulatory Surgery Centers and Methodist Hospital. This position is responsible for completing insurance verification, obtaining and documenting prior authorization approvals from insurance companies for procedures and hospital stays. In collaboration with the Care Team, the Authorization Specialist will obtain and submit clinical documentation pertinent to the specific services requiring authorization for payer review. The Authorization Specialist will maintain and update documentation as it relates to changes in payer prior-authorization, pre-certification and notification requirements by reviewing insurance payer bulletins and publications. This position must attend continuing education classes and complete mandatory training in order to maintain department specific requirements and professional growth. Effective performance of these functions helps the organization achieve strong cash flow and maximize patient’s satisfaction.

Requirements

• High school diploma or equivalent
• Demonstrated P/C and keyboard experience.
• Demonstrated customer service skills.
• Demonstrated written/verbal communication skills.
• Knowledge of EPIC registration and/or any electronic health record
• Ability to work cohesively and respectfully with a diverse work force and patient population.
• Ability to utilize critical thinking skills while working through complex situations
• Knowledge of patient eligibility and related systems
• General knowledge of hospital billing cycle
• Demonstrates effective time management skills and problem-solving skills
• Communicates effectively and maintains composure under stressful situations
• Ability and expectation to successfully complete a competency examination on insurance selection/process upon completion of training and annually thereafter.
• Ability and expectation to demonstrate competency on insurance selection/process on a monthly basis.
• Proficiency with Epic, personal computers with word processing, spreadsheets and email.
• Preference for experience with the Microsoft Suite (e.g. Word, Excel, Outlook).
• Working knowledge of typical office equipment is expected.

Nice To Haves

• Post high school degree or certification.
• Healthcare registration experience.
• Healthcare revenue cycle experience.
• 2 years previous healthcare experience which may include medical terminology, insurance eligibility, prior authorizations, but not limited to ICD/CPT coding experience.

Responsibilities

• creating hospital encounters for surgical services
• completing insurance verification
• obtaining and documenting prior authorization approvals from insurance companies for procedures and hospital stays
• obtain and submit clinical documentation pertinent to the specific services requiring authorization for payer review
• maintain and update documentation as it relates to changes in payer prior-authorization, pre-certification and notification requirements by reviewing insurance payer bulletins and publications
• attend continuing education classes and complete mandatory training

Benefits

• Park Nicollet offers a competitive benefits package (for eligible positions) that includes medical insurance, dental insurance, a retirement program, time away from work, insurance options, tuition reimbursement, an employee assistance program, onsite clinic and much more!

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED