Hybrid Prior Auth Specialist/Clinic Float

Sullivan County Community Hospital•Sullivan, IN

1d•Hybrid

About The Position

The Prior Auth Specialist/Clinic Float is responsible for medication prior authorizations, including accurate and timely processing, appeals as necessary, and resolution of assigned cases. The role also serves as backup for hospital medication prior authorizations when needed and responds to patients’ prior authorization questions. The position works with the Clinical Supervisor on requested project information and fills in as a clinic float or phone nurse when management determines it is necessary. The employee must maintain the clinical skills and duties required by SCCH Clinics. This is a hybrid role, with clinic and remote work at the discretion of the RN Clinical Manager after a 90-day in-clinic probation period. Remote work requires a private, dedicated workspace.

Requirements

Graduate from an accredited Medical Assistant Program or an approved School of Nursing.
Medical Assistant certification or Nursing Licensure in the State of Indiana.
CPR certification.
Knowledge of practice operations, clinical work, and medications.
Commitment to cross-training assigned tasks and customer satisfaction when responding to patient and internal-customer inquiries.
Ability to use office equipment and adapt to changes in procedures or workload.
Excellent written and oral communication skills.
Ability to work independently with little supervision and under pressure with time constraints.
Ability to concentrate.

Responsibilities

Process medication prior authorizations accurately and promptly.
Perform appeals as necessary and work toward resolution of each assigned case.
Provide backup for hospital medication prior authorizations when needed.
Respond promptly to patient needs and answer prior authorization questions.
Facilitate professional and empathetic resolutions for patients.
Work with the Clinical Supervisor to provide requested information for projects.
Fill in as a clinic float or phone nurse when deemed necessary by management.
Maintain and meet all clinical skills and duties required of SCCH Clinics employees.
Consistently comply with established behavioral expectations.
Perform other duties as assigned.