Hybrid Prior Auth Specialist/Clinic Float

Sullivan County Community Hospital • Sullivan, IN

23h • Hybrid

About The Position

The Prior Auth Specialist/Clinic Float handles medication prior authorizations, including accurate and timely processing, appeals when necessary, and resolution of assigned cases. The role may also provide backup for hospital medication prior authorizations. The employee responds to patient prior-authorization questions and works with clinical leadership on requested project information. When management determines it is necessary, the employee fills in as a clinic float or phone nurse and maintains the clinical skills and duties required by SCCH Clinics.

This is a full-time, day-shift position scheduled for 64 hours biweekly. It is hybrid, with in-clinic and remote work at the discretion of the RN Clinical Manager after a 90-day in-clinic probationary period. Remote work requires a private, dedicated workspace. The work environment is a clean, well-lit, well-ventilated general office.

Requirements

• Graduate from an accredited Medical Assistant Program or an approved School of Nursing.
• Knowledge of practice operations, clinical experience, and knowledge of medications.
• Commitment to cross-training assigned tasks and customer satisfaction when responding to internal patient/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, work under pressure with time constraints, and concentrate.
• Medical Assistant certification or nursing licensure in the State of Indiana.
• CPR certification.

Responsibilities

• Process medication prior authorizations accurately and promptly, perform appeals as necessary, and work toward resolution of assigned cases.
• Provide backup for hospital medication prior authorizations when needed.
• Respond promptly to patient needs and answer patient questions about prior authorizations.
• 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 the clinical skills and duties required by SCCH Clinics.
• Comply consistently with established behavioral expectations.
• Perform other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Education Level: Associate degree