Prior Authorization Specialist Physician Practice
About The Position
The Prior Authorization Specialist is responsible for obtaining prior authorization for provider practices, which may include outpatient services, specialty care and other ancillary services. The Prior Authorization Specialist verifies insurance coverage and gathers clinical information to ensure that all reimbursement requirements are met. Franciscan Health is a leading healthcare organization dedicated to providing exceptional patient care and promoting health and wellness in our community. Our mission is to ensure that every patient receives the highest quality of care through innovation, compassion, and excellence. With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers who provide compassionate, comprehensive care for our patients and the communities we serve.
Requirements
- High School Diploma/GED
- 1 year Prior Authorizations and Revenue Cycle Required
Responsibilities
- Serve as primary contact, educator, and resource for all ambulatory department prior authorization requirements and processes.
- Collect clinical and coding information regarding services to be rendered.
- Contact payer to obtain prior authorization.
- Provide standardized documentation within EPIC to identify prior authorization and the criteria surrounding such authorization; stay informed and research information regarding insurance criteria for prior authorization.
- Verify standard documentation and requirements have been met, and advise providers and their clinical staff when issues arise relating to obtaining prior authorization.
Benefits
- Comprehensive benefit offerings
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
