Prior Authorization Specialist
About The Position
Baystate Health, a nationally recognized leader in healthcare quality and safety, and home to Baystate Medical Practices, the largest multispecialty group in the region is looking for a part-time Prior Authorization Specialist to join our experienced Pulmonary team in Springfield, MA. RESPONSIBILITIES: The Prior Authorization Specialist is responsible for obtaining authorizations to ensure reimbursement for pulmonary specialty services and testing provided throughout Baystate Health. Demonstrates excellent communication, strong customer service, critical thinking, and problem-solving skills, insurance knowledge. Completes all appropriate forms, applications, and information for departmental statistics. Accurately manages the referral and authorization process. Able to secure authorization and necessary documentation to ensure patient care is not impacted and meets time-sensitive requests. Is pro-active in troubleshooting instances which could result in great financial loss. Demonstrates excellent customer service skills and works in a positive manner for collaboration and clear communication between providers, staff, insurers, and families. The specialist works closely with the appropriate clinical team members for information gathering and patient data. Participates in departmental meetings and meets all timelines for reports. Meets turnaround expectations for majority of prior authorization approvals.
Requirements
- High School diploma or GED
- 1-3 years of medical insurance knowledge/experience
- Education: GED or HiSET (Required)
Responsibilities
- responsible for obtaining authorizations to ensure reimbursement for pulmonary specialty services and testing provided throughout Baystate Health
- Demonstrates excellent communication, strong customer service, critical thinking, and problem-solving skills, insurance knowledge.
- Completes all appropriate forms, applications, and information for departmental statistics.
- Accurately manages the referral and authorization process.
- Able to secure authorization and necessary documentation to ensure patient care is not impacted and meets time-sensitive requests.
- Is pro-active in troubleshooting instances which could result in great financial loss.
- Demonstrates excellent customer service skills and works in a positive manner for collaboration and clear communication between providers, staff, insurers, and families.
- works closely with the appropriate clinical team members for information gathering and patient data.
- Participates in departmental meetings and meets all timelines for reports.
- Meets turnaround expectations for majority of prior authorization approvals.
Benefits
- Sign on bonus (Sign on Bonuses are paid to external hires only; not applicable for internal or company transfers, unless otherwise specified. Former employees are eligible after 1 year post separation from Baystate Health)
- Excellent Compensation
- High-quality, low-cost medical, dental and vision insurance
- Generous PTO – up to 25 days in the first year, with scheduled earned increases
- Continuing education support and reimbursement
- First Time Home Buyers Financial Packages
- Farm Share Memberships
- 403b retirement company match & annual company contribution increase based on years of service
- Free money coach advice from a certified professional
- Wellbeing programs that include but are not limited to mental, physical, and financial health
- Pet, home, auto and personal insurance
- Life insurance
- Reimbursement for a variety of wellbeing activities, included but limited to gym membership and equipment, personal trainer, massage and so much more!
- Wellbeing programs that include but are not limited to mental, physical, and financial health
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What This Job Offers
Job Type
Part-time
Career Level
Entry Level
Education Level
High school or GED
