Pre Auth Financial Specialist - Admitting

Ivinson Memorial HospitalLaramie, WY
$17

About The Position

At Ivinson Memorial Hospital we are committed to excellence, trust, healing, and integrity. We pride ourselves in providing compassionate, world-class care to our community. At Ivinson we offer a competitive total rewards package including; full medical, dental, and vision insurance, retirement plans, paid time off and tuition reimbursement opportunities. Ivinson aims to improve the care provided for our patients and create a work-life balance for our employees by creating a culture of transparency, teamwork, accountability, and trust. Base salary starts at $17.30/hr .

Requirements

  • High school diploma or equivalent required.
  • Clinical experienced preferred as a CNA, Medical Assistant, Patient Care Technician or Billing coder etc.
  • Clinical experience preferred.
  • Previous experience in insurance verification preferred.
  • Must have current, valid Basic Life Support (BLS) certification or must obtain within 6 months of hire and maintain credentials throughout employment with IMH.
  • Excellent customer service skills, including but not limited to: a friendly personality, tact, patience, empathy and a helpful, professional attitude both in person and on the telephone.
  • Ability to effectively communicate with staff, managers and the general public verbally and in writing.
  • Demonstrate effective listening skills.
  • Excellent organization and time management skills and ability to establish priorities effectively.
  • Possess exceptional problem solving skills.
  • Ability to work effectively without immediate supervision.
  • Ability to learn new computer software programs.
  • Ability to recognize and protect confidential information.
  • Demonstrate ethical and legal accountability for the position.

Responsibilities

  • Compiles and communicates accurate and pertinent clinical data and demographics to the patient’s insurance company.
  • Keeps current on insurance regulations to obtain and record patient data; and maintain knowledge of system requirements.
  • Follow-up with insurance carriers to obtain certification/authorization numbers for outpatient services.
  • Performs on-line data entry of certification/authorization or denials and pre-authorization status.
  • Facilitates resolution of pre-authorization or referral issues for scheduled patients and same day add-ons to insure payment from the insurance company on the patient’s behalf.
  • Works closely with Utilization Review to ensure all notifications, prior authorizations and continued stay reviews are completed as needed.
  • Coordinates with Social Worker when needed.
  • Ensures that all prior authorizations and ongoing authorizations documentation, databases, and records are maintained clearly and accurately, within a timely manner and meet HIPPAA requirements.
  • Coordinates peer to peer reviews with providers for denied requests.
  • Perform clinical reviews of authorization requests using appropriate criteria.
  • Serves as a resource for staff, APP’s and physicians regarding prior authorizations.
  • Collaborates with clinical staff to resolve any problematic authorization issues.
  • Creates payment arrangement forms for uninsured patients and effectively communicates payment requirements to patients.
  • Ensures mail is documented and filed for all patient authorizations.
  • Performs other duties as assigned.
  • Demonstrates consistent use of AIDET (Acknowledge patient, Introduce yourself, provide duration/timeline for test, Explain the process & Thank them for choosing IMH) and HEAL (Hear them out, Empathize, Apologize, & Leap into action to solve) when interacting with patients/customers).
  • Collaborates with all departmental staff to facilitate timely patient care.
  • Participates in performance improvement activities.
  • Attends/participates in staff meetings, in-services, & facility wide meetings as scheduled.

Benefits

  • full medical, dental, and vision insurance
  • retirement plans
  • paid time off
  • tuition reimbursement opportunities
  • Medical, dental, and vision insurance
  • Paid time off: take the time you need to recharge
  • Retirement plans, including 403(b) matching
  • Employer-paid life and long-term disability insurance: Peace of mind for you and your family
  • Yearly work anniversary pay increases
  • Education Reimbursement; up to $2,500 annually
  • Retirement plan participation
  • Free certification classes: enhance your skills at no cost to you
  • Health and Wellness discounts at local gyms
  • Discounts at select mobile networks, local vendors, and Elitch Gardens
  • Mental Health: 6 free confidential, in-person counseling sessions offered by Pathways annually
  • Financial Counseling: free services through WellCents to help you take control of your financial journey
  • Legal assistance and will preparation services
  • Student Loan Forgiveness: Ivinson Memorial Hospital is a qualifying employer for the federal Public Service Loan Forgiveness (PSLF) program

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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

101-250 employees

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