Location: Cherry County Hospital, Valentine, NE
Position: Full-Time (40 hours/week) – Onsite
Compensation: Competitive wage based on experience
Benefits: Eligible for benefits
Now Hiring – Prior Authorization Specialist: About the Position
Cherry County Hospital is seeking a dedicated and detail-oriented Prior Authorization Specialist to join our team. In this important role, you will be responsible for obtaining pre-certifications and pre-authorizations for medical procedures and medications at our hospital and clinic.
Duties and Responsibilities
As a Prior Authorization Specialist, you will:
- Contact insurance carriers to verify patient eligibility, benefits, and requirements.
- Request, track, and obtain pre-authorizations for medical procedures and services.
- Follow up with insurance carriers to ensure timely authorizations before services are performed.
- Demonstrate knowledge of medical terminology, office procedures, and HIPAA regulations.
- Communicate insurance changes or trends to appropriate departments.
- Maintain a level of productivity appropriate for the department.
- Appeal insurance/payor denials when applicable.
- Document all communications and contacts in a standardized format.
- Notify department heads of additional staffing or equipment needs.
- Assist with filing and record retrieval as needed.
- Work cooperatively and effectively with staff, physicians, and the public.
- Maintain strict confidentiality of patient medical, personal, and financial information.
- Follow corporate compliance policies and procedures.
- Perform additional duties as assigned by the supervisor.
Skills and Abilities
- Excellent verbal and written communication skills.
- Proficiency with computers and Microsoft Excel, Word, and Windows.
- Strong organizational skills and ability to interpret data.
- Strong judgment, tact, diplomacy, and problem-solving skills.
- Ability to work collaboratively in a team environment.
- Strong attention to confidentiality of hospital and patient information.
- Ability to perform repetitive tasks with minimal independent judgment.
- Familiarity with state and federal confidentiality laws, including HIPAA, and the ability to follow policies regarding the privacy and security of health information.
Physical Demands and Working Conditions
- Sedentary work involving periods of sitting, talking, typing, and listening.
- Repetitive use of hands, arms, and eyes, which may cause strain.
- Significant manual dexterity required to operate business office machines and equipment.
Job Requirements
- High school diploma required.
- Prior customer service experience in a medical setting preferred.
- Knowledge of medical terminology preferred.
- Previous experience with Microsoft Excel, Word, and Windows.
Comprehensive Benefit Package
- Health Insurance: Co-pay or HSA plan options; 100% paid for employee.
- Dental Insurance: 100% paid for employee.
- Vision Insurance: 100% paid for employee.
- Group Life Insurance: $50,000 with AD&D.
- Long-Term Disability: 100% paid for employee.
- Flexible Spending Accounts: Medical and dependent care options.
- Health Savings Account: Includes employer contribution.
- Supplemental Insurance: Short-Term Disability, Supplemental Life and AD&D, Critical Illness, Hospital Indemnity, and Accident.
- Retirement Plan: 457 plan with Pre-Tax and Roth options.
Why Cherry County Hospital?
- Be part of a dedicated and compassionate healthcare team.
- Enjoy competitive pay and excellent benefits.
- Work in a collaborative and supportive environment.
- Make a meaningful contribution to healthcare in our community.
Apply Now!
Join our team at Cherry County Hospital and help us provide exceptional healthcare services to our community.
Requirements:- High school diploma required
- Prior customer service experience in a medical setting preferred
- Knowledge of medical terminology preferred
- Previous experience with Microsoft Excel, Word, and Windows
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