Job Description

Prior Authorization Specialist, Onsite - This is not a remote position HMC Offers: Tuition Reimbursement Excellent benefits - health, dental, vision, and life and disability insurance Quality childcare located on site HMC Wellness Center membership401(k) plan with employer match Employee Daycare Rates Infants (6 weeks to 15 months) - $133 weekly, $27 daily Toddlers (15 months to 2 yrs) - $126 weekly, $26 daily 2 years to 3 years - $119 weekly, $25 daily 4 years to 5 years - $112 weekly, $23 daily Job Preview The Prior Authorization Specialist is responsible for ensuring that payers are prepared to reimburse Hopedale Medical Complex for scheduled services in accordance with the payer-provider contract. The representative will contact payers to request service authorizations and may collect financial and/or demographic information from patients as needed. The Prior Authorization Specialist is also responsible for determining insurance coverage for tests/procedures and counseling patients regarding this coverage, as well as performing financial counseling duties. This is not a remote position, and candidates must be able to reasonably commute to Hopedale Illinois. Responsibilities Prior Authorizations: Verifies patient’s insurance and benefits information. Obtains prior authorizations from third-party payers in accordance with payer requirements. Works with other departments to gather the clinical information required by the payer to authorize services. Maintains accurate records of authorizations within the EMR. Works with the business office to support appeal efforts for authorization related denials. Complies with HIPAA regulations, as well as the organization's policies and procedures regarding patient privacy and confidentiality. Maintains professional tone at all times when communicating with patients and payer representatives. Other Duties: Completes approved adjustments as requested and adds charges as requested. Keep filing updated for easy access. Keep the waiting area orderly throughout the day. Assist in maintaining accurate patient business records. Orders and maintains supplies as required. Maintains good working relationship both within the department and with other departments. Demonstrates an ability to be flexible, organized and function well in a stressful situation. Treat patients and their families with respect and dignity; ensures confidentiality of patients personal and medical information. Follows established departmental policies, procedures, and objectives. Continues quality improvement objectives and safety, environmental and/or infection control standards. Other duties as assigned by the Patient Access Manager. Compensation details: 19-22 Hourly Wage PI2fc5b0c123b7-25448-39244732aa415a4b-8b21-40fc-a65c-70d2b25ca29a

Job Tags

Hourly pay, Contract work, Work at office, Remote work, Flexible hours,

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