Prior Authorization Specialist
About The Position
Responsible for obtaining patient insurance pre-authorizations and verifications of benefits for rehabilitation procedures for all rehabilitation satellites by successfully completing the insurance verification and authorization process with all payers and notifying the rendering provider in the timeliest manner possible so our patient receives the services needed with the least delay. Other duties include: insurance follow up, patient registration, chart and financial account preparation, medical record tasks, cash drawer/collections, scheduling appointments, financial counseling, obtaining physician orders, and engaging in excellent customer service. Provides organizational and operational support to all clinical staff within the Rehab Department. This position works with the Rehab Practice Manager, Clinical Leaders, and Director to identify business issues and implement operational process improvement. Provides and assures high quality clerical services. Coordinates activities with other services within and outside the Health System to meet and exceed the needs and expectations of our customers.
Requirements
- Knowledge of procedure authorization and its direct impact on the rehab’s revenue cycle
- Understanding of payer medical policy guidelines while utilizing these guidelines to manage authorizations effectively
- Working knowledge of medical terminology and basic understanding of human anatomy, specifically musculoskeletal
- Proficient use of CPT and ICD-10 codes and registration
- Excellent computer skills including Excel, word, and internet use
- Detail oriented with above average organizational skills
- Plans and prioritizes to meet deadlines
- Excellent customer service skills; communicates clearly and effectively
- Ability to multi-task and remain focused while managing high-volume, time-sensitive workload
- High School Diploma or GED required
- Minimum three years of experience in a Customer Service setting
- Computer literacy and working knowledge in Microsoft products
- Experience with multiple telephone lines, excellent communication skills and quality customer relation skills are required
Nice To Haves
- Associates Degree preferred
- Minimum one-year of previous experience in insurance verification and authorizations
- Medical terminology desired
- ICD-10/CPT coding experience strongly desired
- Minimum of two years office employment within a health-related environment
- Medical terminology desired
- ICD-10/CPT coding experience
Responsibilities
- obtaining patient insurance pre-authorizations
- verifications of benefits for rehabilitation procedures
- insurance follow up
- patient registration
- chart and financial account preparation
- medical record tasks
- cash drawer/collections
- scheduling appointments
- financial counseling
- obtaining physician orders
- engaging in excellent customer service
- Provides organizational and operational support to all clinical staff within the Rehab Department
- identify business issues and implement operational process improvement
- Provides and assures high quality clerical services
- Coordinates activities with other services within and outside the Health System
Benefits
- Focus on Employee Wellness : Biometric screenings, Wellness programs, Onsite gym, Zen Room, Community Shared Agriculture program, Access to Success Coach
- Staff Recognition platforms : Shining Stars, CARESCount website
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
