Prior Authorizations Representative | Full Time, Days

Guidehouse•Birmingham, AL

8d•$38,000 - $64,000•Remote

About The Position

Under the direction of the Patient Access Registration Manager, this position is primarily responsible for all insurance notification, verification, and authorization activities necessary to financially secure accounts. Responsibilities include interacting with insurance companies, patients, physician offices and other hospital departments to thoroughly document accounts. Explains financial requirements to patient or other responsible party and collects deposits or deductibles as required.

Requirements

High School Diploma or equivalent
1-3 years of prior relevant experience
The selected candidate must reside within 100 miles of Birmingham, AL.

Nice To Haves

Ability to type a minimum of 35 WPM.
Familiarity with medical terminology
CPAR or CHAA certification

Responsibilities

Performs insurance notification, verification, and authorization activities necessary to financially secure accounts.
While appropriately prioritizing work based on financial risk / difficulty, incumbent completes notification, verification, & authorization for all inpatient, Ambulatory Surgery and bedded outpatient admissions utilizing the HQ work list as the primary work driver.
In a courteous manner, coordinates with and disseminates information to referring physician/hospital clinical staff and the insurance company to ensure that scheduled accounts are secure prior to admit and non-scheduled accounts are secure 24 hours post admit.
Aggressively explores all possible options to secure an account when problems arise (i.e. contacting physician office, referencing past visits, contacting patient, etc.).
Communicates with insurance companies, patients, physician offices and/or other hospital departments to complete account documentation requirements
Responsible for securing patient accounts.
Explains financial requirements to patient or other responsible party.
Collects deposits and deductibles.
Aggressively explores all possible options as a means of securing an account when problems arise.
Informs Patient Access management, registration staff and physician if account is not secure prior to admission.
Coordinates with and disseminates information to referring physician/hospital clinical staff and insurance company to secure scheduled accounts prior to admission and non-scheduled accounts within 24 hours following admission.

Benefits

Medical, Rx, Dental & Vision Insurance
Personal and Family Sick Time & Company Paid Holidays
Position may be eligible for a discretionary variable incentive bonus
Parental Leave
401(k) Retirement Plan
Basic Life & Supplemental Life
Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
Short-Term & Long-Term Disability
Tuition Reimbursement, Personal Development & Learning Opportunities
Skills Development & Certifications
Employee Referral Program
Corporate Sponsored Events & Community Outreach
Emergency Back-Up Childcare Program