Prior Authorization Specialist

Jersey Community Hospital•Jerseyville, IL

1d•Onsite

About The Position

This role involves contacting insurance carriers to verify patient insurance eligibility, benefits, and authorization requirements. The specialist will secure prior authorizations before services are performed, communicate insurance changes and trends to the team and leadership, and document all communications with providers and other personnel. The position requires prioritizing time-sensitive authorizations and maintaining proficiency in multiple EMR systems for demographics, insurance, and clinical information, as well as digital faxing, scanning, and instant messaging tools. Other roles and responsibilities may be assigned.

Requirements

High school graduate or equivalency.
Minimum of two years’ experience in a clinic/hospital billing, prior authorization, and/or insurance verification area.
Demonstrated communication and customer service skills.
Ability to follow oral or written instructions.
Ability to organize and interpret data; judgment, tact, diplomacy and the ability to problem solve.
Work effectively in a team environment; communicate with a variety of professionals.
Knowledge of computers and software required.

Nice To Haves

Associates Degree preferred.
Demonstrated payer knowledge preferred.

Responsibilities

Contact insurance carriers to verify patient's insurance eligibility, benefits, and authorization requirement.
Secure prior authorizations before services are performed.
Communicate insurance changes/trends to team and leadership.
Document all communications/contacts with providers and other personnel.
Prioritize time sensitive authorizations.
Maintain proficiency in multiple EMR systems for demographics, insurance, and clinical information.
Demonstrate proficiency in digital faxing, scanning, and instant messaging communication tools.
Other roles and responsibilities as assigned.