Prior Authorization Specialist I
About The Position
Caring For the Community You Love Choose a career to make a difference in people's lives every day, choose Fisher-Titus! Perks of working at Fisher-Titus: Hours of Work- Full time Comprehensive Benefits Package- Medical & Dental coverage, 401K match, paid time off, tuition assistance and more! Shift, Weekend & PRN differential About Fisher-Titus: Fisher-Titus proudly serves the greater Huron County area’s 70,000-plus residents by providing a full continuum of health and wellness care from heart and cancer care to outpatient services such as lab, imaging, and physical rehabilitation. Vision: Be the first choice for healthcare and employment within our community Mission: Deliver compassionate and convenient care to the highest level of excellence that promotes lifelong health and wellness for our community General Summary: The Prior Authorization Specialist I is responsible for ensuring that payers are prepared to reimburse Fisher-Titus for services in accordance with the payer-provided contract. The Specialist contacts payers to request service authorization and may collect financial and/or demographic information from patients as needed.
Responsibilities
- Verifies patients’ insurance and benefits information
- Obtains prior authorization from third-party payers in accordance with payer requirements
- Will contacts patients to gather demographic and insurance information as needed, and updates patient information within the EMR as necessary
- Works with other departments to gather the clinical information required by the payer to authorize services
- Maintains accurate records of authorizations within the EMR
- Identifies patients who will need to receive Medicare Advance Beneficiary Notices of Noncoverage (ABNs)
- Refers accounts to financial counseling as needed if authorization is not obtained
- Works directly with and supports the needs of the Denial/Appeals committee.
- Complies with HIPAA regulations, as well as the organization's policies and procedures regarding patient privacy and confidentiality
- Continually maintains professional tone when communicating with patients and payer representatives
- Performs other clerical duties as requested
Benefits
- Medical & Dental coverage
- 401K match
- paid time off
- tuition assistance
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
