2 Prior-Authorization Specialist Jobs in Gillette, WY
Hoskinson Health & Wellness Clinic is Hiring a Prior-Authorization Specialist Near Gillette, WY
Duties/ Responsibilities:
Authorization Process Management:
- Review and process prior authorization requests for medical procedures, medications, and other healthcare services
- Ensure all necessary clinical information and documentation are obtained and submitted to insurance companies
- Track and follow up on outstanding prior authorization requests to ensure timely approvals
- Serve as a liaison between healthcare providers, insurance companies, and patients
- Communicate authorization status, requirements, and any potential issues to healthcare providers and patients promptly
- Provide clear and concise information regarding coverage, authorization criteria, and appeal processes
- Maintain accurate and detailed records of all authorization requests, approvals, denials, and appeals
- Ensure compliance with all relevant regulations, guidelines, and clinic policies
- Prepare and submit appeals for denied authorizations when necessary
- Address patient and provider inquiries regarding the prior authorization process
- Provide exceptional customer service by resolving issues and answering questions efficiently and professionally
- Work closely with healthcare providers and administrative staff to gather necessary information for authorization requests
- Collaborate with billing and coding departments to ensure accurate submission of claims
- Assist in the development and implementation of policies and procedures related to prior authorizations
Required
- High school diploma or equivalent required; Associate’s or Bachelor’s degree in healthcare administration, medical billing and coding, or a related field preferred
- Minimum of 2 years of experience in a healthcare setting, preferably in prior authorization, medical billing, or a related field preferred
- Certification in medical billing and coding (e.g., CPC, CMC) is a plus
- Excellent verbal and written communication skills
- Ability to explain complex insurance and authorization processes clearly and concisely
- Strong organizational skills and meticulous attention to detail
- Ability to manage multiple requests and prioritize tasks effectively
- Proficiency with healthcare information systems, electronic medical records (EMR), and prior authorization software
- Familiarity with medical terminology, billing, and coding practices
- Strong analytical and problem-solving skills
- Ability to navigate complex insurance requirements and resolve authorization issues
- Excellent customer service skills with a patient-centered approach
- Ability to work effectively in a team environment and collaborate with various stakeholders
Physical Requirements: Light work - exerting up to 15 pounds of force occasionally (up to 33% of the time). Requires the ability to work designated shift lengths (including 8 and 12 hours).Prolonged periods of sitting at a desk and working on a computer and standing, bending and moving.
Benefits:
- Health Insurance: Employer-sponsored health insurance, including a low-deductible health plan through Cigna, Vision, and Dental
- Additional Insurance: Employer monthly allotment for Disability, Life insurances, Cancer coverage, Accident policies, and more through a supplemental company
- Retirement: Highly matched 401(k)
- PTO & leave: Generous PTO and sick leave with accrual and carry-over opportunities
- Continuing or Additional Education: HH&WC will assist in the professional development of all employees with HR approval
The Clinic is an affirmative action and equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, or genetic information. The Clinic is committed to providing access, equal opportunity, and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. To request reasonable accommodation to participate in the job application or interview process, contact Human Resources at 307-387-9850.
DISCLAIMER: Hoskinson Biotechnology, Hoskinson Health & Wellness Clinic, Hoskinson Construction, and all associated HBT entities are an equal opportunity employer. HBT does not discriminate in employment with regard to race, color, religion, national origin, citizenship status, ancestry, age, sex (including sexual harassment), sexual orientation, marital status, physical or mental disability, military status or unfavorable discharge from military service or any other characteristic protected by law.
I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for HBT to hire me. If I am hired, I understand that either HBT or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of HBT has the authority to make any assurance to the contrary.
I attest with my submission of this application that I have given to HBT true and complete information on this application. No requested information has been concealed. I authorize HBT to contact references provided for employment reference checks. If any information I have provided is untrue, or if I have concealed material information, I understand that this will constitute cause for the denial of employment or immediate dismissal.
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Job Summary
Full Time
$37k-44k (estimate)
06/09/2024
07/07/2024
The job skills required for Prior-Authorization Specialist include Prior Authorization, Customer Service, Coordination, Problem Solving, Written Communication, Medical Billing, etc. Having related job skills and expertise will give you an advantage when applying to be a Prior-Authorization Specialist. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Prior-Authorization Specialist. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Prior-Authorization Specialist positions, which can be used as a reference in future career path planning. As a Prior-Authorization Specialist, it can be promoted into senior positions as an Admitting Supervisor that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Prior-Authorization Specialist. You can explore the career advancement for a Prior-Authorization Specialist below and select your interested title to get hiring information.
If you are interested in becoming a Prior Authorization Specialist, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become a Prior Authorization Specialist for your reference.
Step 1: Understand the job description and responsibilities of an Accountant.
Quotes from people on Prior Authorization Specialist job description and responsibilities
Request, follow up and secure prior-authorizations prior to services being performed.
04/09/2022: Laramie, WY
Receive requests for pre-authorizations and ensure that they are properly and closely monitored.
03/28/2022: Schenectady, NY
Contact insurance carriers to verify patient’s insurance eligibility, benefits and requirements.
02/27/2022: Wichita, KS
Request, track and obtain pre-authorization from insurance carriers within time allotted for medical and services.
04/08/2022: Altus, OK
Reported to supervisor to assure accurate capture of services needing authorization.
02/05/2022: Dothan, AL
Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.
Career tips from people on Prior Authorization Specialist jobs
Prior Authorization Specialist must have excellent computer skills including Excel, Word, and Internet use.
02/12/2022: New Britain, CT
A good Prior Authorization Specialist are those who are detail oriented with above average organizational skills.
03/28/2022: Galveston, TX
Basic understanding of human anatomy, specifically musculoskeletal would also give you benefits for this role.
04/04/2022: Lebanon, PA
Some experience in medical billing or insurance authorization are strongly preferred by most employers.
03/10/2022: Jamestown, NY
Licenses and certifications are not usually required to work as a prior authorization specialist.
04/02/2022: Mcallen, TX
Step 3: View the best colleges and universities for Prior Authorization Specialist.
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