PAIN & SPINE - INSURANCE PRE-AUTHORIZATION SPECIALIST
About The Position
Mountain View Hospital is looking for an Insurance Pre-Authorization Specialist to join our team! JOB SUMMARY: Checks appointments and tasks/messages to make sure the diagnosis/documentation will support medical necessity, as per insurance company, and verify that all office visits and procedures that need preauthorization are pre-authorized. Works closely with referring offices to be used as a resource in helping them get necessary paperwork to start pre-authorizations, prove medical necessity, or to perform a retro-authorization. Works closely with co-workers and vendor representatives to get visits/procedures approved. About Mountain View: Mountain View Hospital and our 29 affiliate clinics are committed to providing compassionate, cutting edge care to our patients. We serve the entire Snake River Valley – all the way from Pocatello to Rexburg. Our medical capabilities span everything from wound care to urgent care, oncology to neurology, physical therapy to speech therapy, a Level III NICU, robust robotic surgery department and a continuously expanding rural health practice. Our work environment is mission driven, people-centric and supportive. It is what sets apart and makes people excited to come to work each day. If you are looking for a career where you can make a difference in your community, we invite you to apply. About Mountain View: Mountain View Hospital and our 29 affiliate clinics are committed to providing compassionate, cutting edge care to our patients. We serve the entire Snake River Valley – all the way from Pocatello to Rexburg. Our medical capabilities span everything from wound care to urgent care, oncology to neurology, physical therapy to speech therapy, a Level III NICU, robust robotic surgery department and a continuously expanding rural health practice. Our work environment is mission driven, people-centric and supportive. It is what sets apart and makes people excited to come to work each day. If you are looking for a career where you can make a difference in your community, we invite you to apply.
Requirements
- Education: High School graduate or equivalent.
- Knowledge of diagnoses and CPT codes for pain management services preferred.
- Language/Communication: Ability to communicate well with patients, co-workers and vendor representatives.
- Mental Capabilities: Continuously able to concentrate on fine detail with interruptions and continuously able to attend to task/function for an extended period of time. Ability to learn computer programs and input data as required.
- Interpersonal: Ability to work well with others.
- Performance: Writing skills necessary to properly submit preauthorization requests with insurance companies. Appropriate phone etiquette to properly submit preauthorization requests with insurance companies. Holds the judgment, tact and diplomacy to effectively resolve conflicts.
Nice To Haves
- Experience: Prior experience with coding and billing for outpatient billing is preferred.
Responsibilities
- Checks appointments and tasks/messages to make sure the diagnosis/documentation will support medical necessity, as per insurance company, and verify that all office visits and procedures that need preauthorization are pre-authorized.
- Works closely with referring offices to be used as a resource in helping them get necessary paperwork to start pre-authorizations, prove medical necessity, or to perform a retro-authorization.
- Works closely with co-workers and vendor representatives to get visits/procedures approved.
Benefits
- Medical, Dental and Vision Insurance
- Paid Time Off (vacation, holidays and sick days) and Medical Paid Time Off
- Retirement Plans (401K with up to 6% match)
- Earned Quarterly Bonus Program
- Education Reimbursement Program
- Discount for medically necessary procedures performed at Mountain View Hospital and Idaho Falls Community Hospital
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
1,001-5,000 employees
