What are the responsibilities and job description for the Pre Authorization Technician - Patient Access Department - Full Time Remote Work Schedule position at Alaska Native Tribal Health Consortium (ANTHC)?
The Alaska Native Tribal Health Consortium is a non-profit Tribal health organization designed to meet the unique health needs of Alaska Native and American Indian people living in Alaska. In partnership with the more than 171,000 Alaska Native and American Indian people that we serve and the Tribal health organizations of the Alaska Tribal Health System, ANTHC provides world-class health services, which include comprehensive medical services at the Alaska Native Medical Center, wellness programs, disease research and prevention, rural provider training and rural water and sanitation systems construction.
ANTHC is the largest, most comprehensive Tribal health organization in the United States, and Alaska’s second-largest health employer with more than 3,100 employees offering an array of health services to people around the nation’s largest state.
Our vision: Alaska Native people are the healthiest people in the world.
ANTHC offers a competitive and comprehensive Benefits Package for all Benefit Eligible Employees, which includes:
Alaska Native Tribal Health Consortium has a hiring preference for qualified Alaska Native and American Indian applicants pursuant to P.L. 93-638 Indian Self Determination Act.
Under general supervision, perform tasks on behalf of Alaska Native Tribal Health Consortium Specialty Clinics Outpatient Departments and various insurance carriers for the purpose of obtaining insurance prior authorization for medical procedures being performed at Alaska Native Medical Center.
Responsibilities
Preform reviews of pending medical procedures identified in the Electronic Health Care Record Scheduling Application and identify those procedures that will require pre-authorization. Working closely with the Clinical Referral Specialists to determine medical necessity and assisting in communicating with the various insurance carriers to obtain pre-authorization clearance. Document appropriate information concerning status of pre-authorization in all necessary systems.
As necessary, enter all billing information into the electronic billing system. Report tracking and performance information to the supervisor as requested. Be available to support training department staff and providers as subject matter experts concerning pre-authorization.
Support all clinical improvement activities, regulatory compliance, policy/procedure adherence and organizational strategic initiatives.
Performs other duties as assigned.
Other Information
KNOWLEDGE and SKILLS
A high school diploma or GED and 1 year of medical office experience or insurance verification. An equivalent combination of relevant training or education may be substituted.
ANTHC is the largest, most comprehensive Tribal health organization in the United States, and Alaska’s second-largest health employer with more than 3,100 employees offering an array of health services to people around the nation’s largest state.
Our vision: Alaska Native people are the healthiest people in the world.
ANTHC offers a competitive and comprehensive Benefits Package for all Benefit Eligible Employees, which includes:
- Medical Insurance provided through the Federal Employee Health Benefits Program as a Tribal Employee, with over 20 plans and tiers.
- Cost-Share Dental and Vision Insurances
- Discounted Pet Insurance
- Retirement Contributions with Pre-Tax or Roth options into a 403(b).
- Retirement Match and Discretionary. ANTHC matches up to 5%, with a 3% discretionary contribution after one year of employment into a 401(a).
- Paid Time Off starts immediately, earning up to 6 hours per pay period, with paid time off accruals increasing based on years of service.
- Twelve Paid Holidays
- Paid Parental Leave or miscarriage/stillbirth eligibility after six months of employment
- Basic Short/Long Term Disability premiums, Accidental Death and Dismemberment (AD&D) Insurance, and Basic Life Insurance are covered 100% by ANTHC, with additional options for Short-Term Disability Buy-Up Coverage and Voluntary Life for yourself and your family members.
- Flexible Spending Accounts for Healthcare and Dependent Care.
- Ancillary Cash Benefits for accident, hospital indemnity, and critical illness.
- On-Site Child Care Facility with expert-designed classrooms for early child development and preschool.
- Employee Assistance Program with support for grief, financial counseling, mental/emotional health, and discounted legal advice.
- Tuition Discounts for you and your eligible dependents at Alaska Pacific University.
- On-Site Training Courses and Professional Development Opportunities.
- License and certification reimbursements and occupational insurance for medical staff.
- Gym Access to Alaska Pacific University includes a salt water pool, rock climbing, workout gym, and steep discounts for outdoor equipment rentals.
- Emergency Travel Assistance
- Education Assistance or Education leave eligibility
- Discount program for travel, gym memberships, amusement parks, and more.
Alaska Native Tribal Health Consortium has a hiring preference for qualified Alaska Native and American Indian applicants pursuant to P.L. 93-638 Indian Self Determination Act.
- This position is full-time remote work schedule.
Under general supervision, perform tasks on behalf of Alaska Native Tribal Health Consortium Specialty Clinics Outpatient Departments and various insurance carriers for the purpose of obtaining insurance prior authorization for medical procedures being performed at Alaska Native Medical Center.
Responsibilities
Preform reviews of pending medical procedures identified in the Electronic Health Care Record Scheduling Application and identify those procedures that will require pre-authorization. Working closely with the Clinical Referral Specialists to determine medical necessity and assisting in communicating with the various insurance carriers to obtain pre-authorization clearance. Document appropriate information concerning status of pre-authorization in all necessary systems.
As necessary, enter all billing information into the electronic billing system. Report tracking and performance information to the supervisor as requested. Be available to support training department staff and providers as subject matter experts concerning pre-authorization.
Support all clinical improvement activities, regulatory compliance, policy/procedure adherence and organizational strategic initiatives.
Performs other duties as assigned.
Other Information
KNOWLEDGE and SKILLS
- Knowledge of health care operations and insurance pre-authorization
- Knowledge of general medical terminology, general anatomy, general physiology and general concepts of disease
- Knowledge of CPT and ICD-10 codes
- Knowledge of various insurance carriers regulations to determine medical necessity
- Knowledge of Centers for Medicare and Medicaid regulations
- Skill in customer service with strong communication skills using the telephone and electronic media
- Skill in operation of a personal computer utilizing various software including electronic health records and on-line application processes
A high school diploma or GED and 1 year of medical office experience or insurance verification. An equivalent combination of relevant training or education may be substituted.
