Pre-Authorization Specialist - FQHC
About The Position
Pre-authorization Specialist is responsible for the patient registration process, infusion center admissions, co-pay cash collection, and financial arrangement issues. This position verifies third party payer accounts, pre-authorization and/or pre-certification requirements. In addition, this position will be responsible for interfacing with all private payers or their designees to obtain authorization for treatments and or imaging/lab studies and will facilitate physician to physician peer reviews of questionable cases. This position assures assignment of appropriate codes and Diagnosis Related Group (DRG) codes, collects quality statistical information, and assures timely follow up and processing of all accounts. Finally, this position will perform charge data reconciliation of all infusion accounts. This position also collects data for statistical and/or financial analysis. This position will require ongoing communication and collaboration with the infusion team members and provides quality customer service This position supports organizational goals by providing quality customer service, participating in performance improvement efforts and demonstrating a commitment to teamwork and cooperation.
Requirements
- High school diploma or equivalent required.
- Ability to read, write, and speak English is required.
- 1-3 years medical office experience required, healthcare preferably in a medical setting.
- Knowledge of general computer and data entry functions required.
Nice To Haves
- Knowledge of medical or dental terminology preferred.
Responsibilities
- Patient registration process
- Infusion center admissions
- Co-pay cash collection
- Financial arrangement issues
- Verifies third party payer accounts
- Pre-authorization and/or pre-certification requirements
- Interface with all private payers or their designees to obtain authorization for treatments and or imaging/lab studies
- Facilitate physician to physician peer reviews of questionable cases
- Assures assignment of appropriate codes and Diagnosis Related Group (DRG) codes
- Collects quality statistical information
- Assures timely follow up and processing of all accounts
- Perform charge data reconciliation of all infusion accounts
- Collects data for statistical and/or financial analysis
- Ongoing communication and collaboration with the infusion team members
- Provides quality customer service
Benefits
- Generous Paid Time Off (PTO)
- Medical, Prescription Drug, Dental & Vision Insurance
- Retirement Plans with employer contributions
- Short-Term & Long-Term Disability Coverage
- Life & Accidental Death & Dismemberment Insurance
- Tuition Reimbursement to support your educational goals
- Flexible Spending Accounts (FSAs) for healthcare and dependent care
- Wellness Programs to help you thrive
- Voluntary Benefits, including Pet Insurance and more
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
