Prior Authorization Rep - Part Time

BJC HealthCare • Belleville, IL

1d • Onsite

About The Position

Memorial Hospital is looking for a Part-time Prior Auth Rep for their Sleep Disorders Center. This role is critical in the financial clearance process which assists BJC hospitals enterprise wide in securing the appropriate authorization and/or Notice Of Admission (NOA) in order to prevent rescheduling the patient or risking net revenue loss. This position is required to obtain authorization on behalf of some physicians at Washington U school of medicine and BJC medical group and must maintain positive relationships. This position ensures technology is built in a way to accurately support the scripting and validation of authorization and NOA. Without the above we are limited in our collection of payment. The role represents BJC with the highest standard of customer service, compassion and performs all duties in a manner consistent with our mission, vision, values, and service standards. Facilitates certain components of the patients' entrance into any BJC facility, including insurance validation, benefit verification, pre-certification & financial clearance. Responsible for ensuring that the most accurate patient data is obtained and populated into the patient record, particularly authorization data and status. This team member must possess exceptional attention to detail & maintain knowledge & competence with insurance carriers, Medicare guidelines & federal, state & accreditation agencies.

Requirements

• High School Diploma or GED
• 2-5 years of experience
• Ability to work in a constant state of alertness and in a safe manner.

Nice To Haves

• Associate's Degree
• 5-10 years of experience
• CHAA certification

Responsibilities

• Patient Registration
• Handling Surgery Prior Authorizations
• Scheduling appointments
• Validation of patient information, scheduled test/surgery information, and insurance information.
• Ensures that the authorization detail placed in the patient’s medical record is accurate.
• Utilize critical thinking skills to research and resolve any mismatch in information which could involve various orders/scheduling, registration and insurance systems.
• Follow departmental processes around data capture.
• Communicate in a professional manner with particular emphasis on positive and respectful interaction with patients and offices.
• Provide consistent excellent customer service in a variety of situations.
• Contribute to opportunities to improve employee engagement and customer satisfaction.
• Engage others in a respectful and collaborative manner.
• Seek opportunities for self-development (personal and technical) while achieving department objectives and goals.
• May be responsible for supporting the Ancillary Authorization (scheduled outpatient services), Surgery Authorization (scheduled surgical procedures), or the NOA (Notice of Admission) processes within the BJC Pre-Arrival Team.
• Initiate contact with provider offices, payers and/or payer websites as well as access a variety of systems and tools to secure and validate authorization information.
• For Ancillary Authorizations, a review of medical records may be required if initiating the authorization request directly with a payer.
• Ability to work in a constant state of alertness and in a safe manner.

Benefits

• Comprehensive medical, dental, vision, life insurance, and legal services available first day of the month after hire date
• Disability insurance paid for by BJC
• Annual 4% BJC Automatic Retirement Contribution
• 401(k) plan with BJC match
• Tuition Assistance available on first day
• BJC Institute for Learning and Development
• Health Care and Dependent Care Flexible Spending Accounts
• Paid Time Off benefit combines vacation, sick days, holidays and personal time
• Adoption assistance

What This Job Offers

• Job Type: Part-time
• Career Level: Mid Level
• Education Level: High school or GED