MV INFUSION - INSURANCE PRE-AUTHORIZATION SPECIALIST

MOUNTAIN VIEW HOSPITAL LLC • Idaho Falls, ID

153d • Onsite

About The Position

Mountain View Hospital is looking for an Insurance Pre-Authorization Specialist to join our team! This role is responsible for checking appointments and tasks/messages to ensure that the diagnosis and documentation support medical necessity as per insurance company guidelines. The specialist will verify that all office visits and procedures requiring pre-authorization are indeed pre-authorized. This position involves close collaboration with referring offices, acting as a resource to help them obtain necessary paperwork for pre-authorizations, prove medical necessity, or perform retro-authorizations. Additionally, the specialist will work with co-workers and vendor representatives to secure approvals for visits and procedures. Mountain View Hospital and its affiliate clinics are dedicated to providing compassionate, cutting-edge care. The work environment is mission-driven, people-centric, and supportive, offering a chance to make a difference in the community.

Requirements

• High School graduate or equivalent.
• Ability to communicate well with patients, co-workers and vendor representatives.
• 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.
• Ability to work well with others.
• 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

• Knowledge of diagnoses and CPT codes for authorizing infusion services.
• Prior experience with coding and billing for outpatient billing.

Responsibilities

• Checks appointments and tasks/messages to make sure the diagnosis/documentation will support medical necessity, as per insurance company.
• 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 Insurance
• Dental Insurance
• Vision Insurance
• Paid Time Off (vacation, holidays and sick days)
• 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

What This Job Offers

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