Prior Authorization Spclst
About The Position
About Children’s Minnesota Children’s Minnesota is one of the largest pediatric health systems in the United States and the only health system in Minnesota to provide care exclusively to children, from before birth through young adulthood. An independent and not-for-profit system since 1924, Children’s Minnesota is one system serving kids throughout the Upper Midwest at two free-standing hospitals, nine primary care clinics, multiple specialty clinics and seven rehabilitation sites. As The Kids Experts™ in our region, Children’s Minnesota is regularly ranked by U.S. News & World Report as a top children’s hospital. Find us on Facebook @childrensminnesota or on Twitter and Instagram @childrensmn. Please visit childrensMN.org . Children’s Minnesota is proud to be recognized by Modern Healthcare as one of 2023’s Top Diversity Leaders. The national honor recognizes the top diverse healthcare executives and organizations influencing public policy, care delivery, and promoting diversity, equity and inclusion in their organizations and the industry. Department Overview The Patient Registration and Insurance Verification department is involved in gathering demographic and insurance information for inpatients, outpatients, surgical patients and Emergency Department patients. Position Summary The Prior Authorization Specialist promotes an excellent patient experience by ensuring authorizations are in place for services performed at Children's Minnesota prior to their admission to our facilities to secure payment and reduce the out of pocket costs to our patients and families. This position is responsible for all duties associated with prior authorizations including reviewing insurance benefits, understanding third party requirements, securing authorizations for services and appealing authorization denials.
Requirements
- High School Diploma or GED
- One year of related experience in a healthcare or related field.
- Knowledge in governmental and commercial payors, medical billing requirements, and prior authorizations.
- Demonstrated knowledge of Prior Authorization operations and medical office and/or hospital procedures.
- Ability to interpret and cascade payor requirements as they relate to insurance prior authorizations.
- Ability to effectively work in both a team environment and independently.
- Ability to establish and maintain effective working relationships with providers, patients, families, and employees.
- Ability to effectively work in a remote environment and connect via multiple communication channels (phone, email, text, etc.).
- Knowledge of how prior authorization functions impact billing, clinical teams, the quality of care and the patient experience.
- Ability to meet departmental quality, production and prior authorization standards.
- Skill in Microsoft Office.
- Skill in written and oral communication.
Nice To Haves
- One year experience in medical billing/prior authorization/insurance.
Responsibilities
- This position is responsible for all duties associated with prior authorizations including reviewing insurance benefits, understanding third party requirements, securing authorizations for services and appealing authorization denials.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
