Prior Authorization Specialist (1.0 FTE)

SPH Careers 2023 • Helena, MT

12d

About The Position

The primary function of the Prior Authorization Specialist position is to provide premier customer service to the patient, physician and office staff by obtaining facility authorizations for patients scheduled at SPH. This position will be required to verify insurance coverage and obtain insurance authorizations. The Specialist is required to maintain a working knowledge of all Managed Care Contracts as well as insurance requirements and policies for authorizations, notifications and/or referrals. The Specialist position will utilize the system functionality as well as office equipment such as a scanner, credit card terminals and fax machine. This position will be in communication with outside physician offices and ancillary departments within the hospital to complete an accurate patient record.

Requirements

• Ability to achieve cognitive, organization and emotional maturity to deal effectively with multiple tasks, stresses, deadlines, difficult situations and/or customers.
• Possesses interpersonal/communication skills necessary for effective, non-judgmental, and empathetic patient care and customer relations.
• Open to feedback, and open to a changing environment, which requires flexibility in scheduling and department assignments.
• Create, maintain, and promote a respectful work environment consistent with SPH patient and employee satisfaction culture.
• Attention to detail and accuracy.
• Ability to accurately and efficiently document customer interactions.
• Possess a customer-focused mindset

Responsibilities

• Obtaining facility authorizations for patients
• Verify insurance coverage
• Obtain insurance authorizations
• Maintain a working knowledge of all Managed Care Contracts
• Maintain knowledge of insurance requirements and policies for authorizations, notifications and/or referrals
• Utilize system functionality
• Communicate with outside physician offices and ancillary departments within the hospital to complete an accurate patient record

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed