PAIN & SPINE - INSURANCE PRE-AUTHORIZATION SPECIALIST
About The Position
Mountain View Hospital is seeking an Insurance Pre-Authorization Specialist for Pain Specialists Idaho Falls in Idaho Falls, Idaho. The role checks appointments and tasks or messages to ensure diagnoses and documentation support medical necessity under insurance requirements, and verifies that office visits and procedures requiring preauthorization are authorized. The specialist works with referring offices to obtain paperwork needed for preauthorizations, demonstrate medical necessity, or complete retro-authorizations. The position also involves working with coworkers and vendor representatives to secure approval for visits and procedures. Mountain View Hospital and its 29 affiliate clinics provide care across the Snake River Valley. The organization describes its work environment as mission-driven, people-centric, and supportive.
Requirements
- High school graduate or equivalent.
- Ability to communicate well with patients, coworkers, and vendor representatives.
- Ability to concentrate on fine detail despite interruptions and attend to tasks or functions for extended periods.
- Ability to learn computer programs and input data as required.
- Ability to work well with others.
- Writing skills necessary to properly submit preauthorization requests to insurance companies.
- Appropriate phone etiquette for submitting preauthorization requests to insurance companies.
- Judgment, tact, and diplomacy to effectively resolve conflicts.
Nice To Haves
- Knowledge of diagnoses and CPT codes for pain management services.
- Prior experience with coding and billing for outpatient billing.
Responsibilities
- Review appointments and tasks or messages to ensure diagnoses and documentation support medical necessity under insurance requirements.
- Verify that office visits and procedures requiring preauthorization have been pre-authorized.
- Work with referring offices to obtain paperwork for preauthorizations, establish medical necessity, or complete retro-authorizations.
- Work with coworkers and vendor representatives to obtain approval for visits and procedures.
- Submit preauthorization requests to insurance companies using appropriate writing skills and phone etiquette.
- Learn computer programs and enter data as required.
- Resolve conflicts using appropriate judgment, tact, and diplomacy.
Benefits
- Medical insurance
- Dental insurance
- Vision insurance
- Paid time off for vacation, holidays, and sick days
- Medical paid time off
- 401(k) retirement plan 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
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Education Level
High school or GED
