Insurance Authorization Representative

Sturdy Memorial Hospital•Attleboro, MA

1d•$20 - $30•Hybrid

About The Position

The Insurance Authorization Representative is responsible for determining and monitoring the insurance and authorization status of all Inpatient, Observation and Surgical Day Care accounts. This role is also responsible for tracking and arranging copayment collection where applicable. The position requires a High School diploma or equivalent and involves interacting with patients, physician offices, insurance companies, and various hospital departments. The representative will also work closely with the case management department to ensure clinical information is sent to payers and follow up on prior authorization status.

Requirements

Minimum of 1-3 years of experience in a health care related field.
Interpersonal skills to effectively interact with patients, physician offices, insurance companies and departments throughout the hospital.
Excellent typing skills.
Ability to use computer and office equipment.
High School diploma or equivalent.

Nice To Haves

Previous experience obtaining prior authorizations from payers.
Third party knowledge.
Business experience.
Healthcare terminology/knowledge.
Computer skills.

Responsibilities

Determine and monitor the insurance and authorization status of all Inpatient, Observation and Surgical Day Care accounts.
Track and arrange copayment collection where applicable.
Run payer eligibility.
Call payers and/or electronically obtain prior authorization for departments within the hospital.
Work with outside offices to insure they are obtaining Prior Authorization.
Work closely with case management department to insure clinicals have been sent to the payer.
Run daily reports as required.
Call payers for follow-up on prior authorization status.