Insurance Specialist - Spencer Hospital

Avera • Spencer, IA

1d • Onsite

About The Position

Spencer Hospital is proud to employ highly skilled and caring staff members. We offer competitive salaries and benefits as well as a pleasant work environment. Position Highlights Spencer Hospital is a rural hospital located in northwest Iowa employing over 500+ employees. Positions at Spencer Hospital are not affiliated with Avera; however, we collaborate to provide services to the communities we serve. Employment offers, if accepted, are exclusively with Spencer Hospital.

Requirements

• High school graduate or equivalent
• Prior hospital and/or clinic authorization experience preferred

Responsibilities

• Coordinate with clinical staff in order to complete prior authorization for all services and procedures in an accurate and timely manner
• Ensure that all supporting documentation is available and shared with payers to expedite authorizations
• Maintaining authorizations, which includes gathering necessary documents to support authorization requests, submitting initial requests for authorization, following up on authorization requests, and communicating with departments and providers on status of authorizations
• Coordinate with providers as needed to ensure treatments/services meet medical necessity criteria.
• Assist with appeals for claim denials due to the authorization process.
• Develop and implement prior authorization workflow, policies and procedures
• Collaborate with other departments to assist in obtaining pre-authorizations in a cross functional manner.
• Share information with providers and staff regarding coverage criteria, medically necessary criteria

Benefits

• competitive wages
• affordable insurance
• IPERS retirement
• in-house education
• paid time off
• family gym membership

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