Prior Authorization Specialist

Konza Prairie Community Health Center • Junction City, KS

17h

About The Position

Konza Prairie Community Health Center is seeking a highly motivated Prior Authorization Specialist to join our team. This position plays a vital role in coordinating patient care by managing all aspects of prior authorizations, referrals, and medical record correspondence to ensure accuracy, timeliness, and continuity of care.

Requirements

• High school diploma or GED required.
• Minimum 1 year of experience with electronic medical records required.
• At least 2 years of face-to-face experience with medical patients preferred.
• At least 4 years of customer service experience preferred.
• Knowledge of healthcare payment methodologies, including Medicare, Medicaid, HMOs, PPOs, and secondary payers, preferred.
• Minimum 1 year of experience in a family practice or hospital setting preferred.
• Completion of a certified medical office training course preferred.

Responsibilities

• Collaborate with third parties (insurance companies, hospitals, imaging facilities) to obtain prior authorizations and schedule patient medical services.
• Process, maintain, and close prior authorization requests.
• Follow up with specialty provider offices and close referral loops upon receipt of consult notes or results.
• Categorize and assign incoming lab and diagnostic imaging results to the appropriate provider.
• Manage refill requests from outside pharmacies and ensure accurate communication with providers.
• Maintain third-party portals for shared medical records to ensure prompt referral closure.
• Prioritize and process referrals based on urgency or provider request.
• Complete prior authorizations for outbound referrals and diagnostic imaging.
• Sort, file, and manage medical records (admission slips, lab/pathology reports, operative notes, clinic notes, discharge summaries) ensuring proper sequencing and compliance.
• Retrieve and track missing medical records as needed.
• Review records for completeness and follow up on missing documentation.
• Manage incoming faxes by categorizing, distributing, and attaching documents to the correct records.
• Participate in quality improvement activities and other duties as assigned.

Benefits

• Medical, Dental, and Vision Coverage: Take advantage of our robust health plans to ensure you and your family's well-being.
• Paid Time Off (PTO): Generous PTO accrual of up to 7.71 hours per pay period for a healthy work-life balance.
• 403(b) Retirement Plan with Employer Match: Secure your financial future with our retirement savings plan, complemented by employer contributions.
• Employee Discounts: Insured employees can enjoy exclusive discounts when utilizing Konza's in-house medical, dental, and pharmacy services.
• Early Friday Closure: Konza clinics close at 2:00 pm every Friday, allowing you to kick off your weekend early.

What This Job Offers

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