Prior Authorization Specialist

Cherry County Hospital • Valentine, NE

5m • $21 • Onsite

About The Position

Cherry County Hospital is seeking a dedicated and skilled Prior Authorization Specialist to join our team. In this vital role, you will be responsible for obtaining pre-certifications and pre-authorizations for medical procedures and medications at our hospital and clinic.

Requirements

• High school diploma required
• Excellent verbal and written communication skills
• Proficiency with computers and related software (Microsoft Excel, Word, and Windows)
• Strong organizational skills and the ability to interpret data
• Strong judgment, tact, diplomacy, and problem-solving skills
• Ability to work collaboratively in a team environment
• Strong attention to maintaining confidentiality of hospital and patient information
• Ability to perform repetitive tasks with minimal independent judgment
• Familiarity with state and federal confidentiality laws, including HIPAA, and the ability to follow policies regarding the privacy and security of health information

Nice To Haves

• Prior customer service experience in a medical setting preferred
• Knowledge of medical terminology preferred
• Previous experience with Microsoft Excel, Word, and Windows

Responsibilities

• Contact insurance carriers to verify patient insurance eligibility, benefits, and requirements
• Request, track, and obtain pre-authorizations for medical procedures and services
• Follow up with insurance carriers to ensure timely authorizations before services are performed
• Demonstrate a solid understanding of medical terminology and office procedures, including HIPAA regulations
• Communicate any insurance changes or trends to relevant departments
• Maintain a level of productivity suitable for the department
• Appeal insurance/payor denials when applicable
• Document all communications and contacts in a standardized format
• Notify department heads of any additional staffing or equipment needs
• Assist with occasional filing or record retrieval as needed
• Cooperate and work effectively with staff, public, and physicians
• Ensure the confidentiality of all patient medical, personal, and financial records
• Practice and adhere to corporate compliance policies and procedures
• Perform additional duties as assigned by the supervisor

Benefits

• Eligible for benefits
• Competitive pay

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED