Authorization Specialist

HealthPartners•Saint Paul, MN

1d•$23 - $34•Onsite

About The Position

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.
Working knowledge of typical office equipment is expected.

Nice To Haves

Preference for experience with the Microsoft Suite (e.g. Word, Excel, Outlook).

Responsibilities

Creating hospital encounters for surgical services throughout Park Nicollet Ambulatory Surgery Centers and Methodist Hospital.
Completing insurance verification.
Obtaining and documenting prior authorization approvals from insurance companies for procedures and hospital stays.
Obtaining and submitting clinical documentation pertinent to the specific services requiring authorization for payer review.
Maintaining and updating documentation as it relates to changes in payer prior-authorization, pre-certification and notification requirements by reviewing insurance payer bulletins and publications.
Attending continuing education classes and completing mandatory training.