What are the responsibilities and job description for the Pre-Auth Specialist (Digestive Care Clinic) position at Clark Regional Medical Center?
About Us
Lifepoint Health’s Central Kentucky market is comprised of four acute care, community-based hospitals, with over 50 outpatient clinics that provide comprehensive healthcare in the Bluegrass region. Bluegrass Community Hospital (Versailles, KY), Bourbon Community Hospital (Paris, KY), Clark Regional Medical Center (Winchester, KY), and Georgetown Community Hospital (Georgetown, KY) are committed to our mission of making communities healthier. As an integrated network, our facilities have the ability and resources to develop opportunities for professional growth and advancement to accomplish your career goals. We take pride in personalized patient care backed by high-quality designations to support a culture of safety for both employees and patients. Get back to the heart of your community by caring for your neighbors - join our team today!
A Career with Us Offers:
- Newly Adjusted Competitive Pay Rates
- Paid Time Off (PTO)
- Extended Illness Benefit (EIB)
- Flexible Spending Accounts (FSA)
- Choice of Insurance Plans (Health, Dental, Vision, Life)
- Educational Assistance
- Bereavement Leave
- 401(k) Match
- Free Parking
The Prior Authorization Specialist is responsible for successfully obtaining prior authorization and sometimes eligibility verification for patients with all commercial payers. This entails having a strong background in obtaining authorizations, understanding and having the ability to navigate through the challenging environment of healthcare insurance verification and approvals, as well as ultimately scheduling the patient for the procedure. Excellent customer service skills are necessary to serve the needs of the patient, the provider and the payer. The PA Specialist is also a clinical role which functions as an adjunct to the clinic nurse in times of a busy clinic.
JOB REQUIREMENTS
Minimum Education
2 years medical prior authorization experience preferred
Previous EMR/EHR experience
Knowledge of health insurance concepts (i.e., Medicare, Medicaid, MCR Advantage Plans, HMO, PPO, etc.).
Proficient computer skills. Exceptional customer service skills. Proficient and accurate data entry skills.
Ability to multi-task, prioritize work as needed based on urgency and turnaround time. Ability to make sound judgments. Ability to remain patient during long periods of telephonic hold times.
Other duties as assigned as necessary and may vary at times, as needed, by your immediate supervisor or as directed by the company.
Prolonged sitting. Repetitive motion (data entry), and phone contact.
Required Skills
Excellent customer service skills; communicates clearly and effectively as part of a team;
Knowledge of procedure authorization and its direct impact on the practice’s revenue cycle
Understanding of payer medical policy guidelines in order to manage authorizations effectively
Basic understanding of human anatomy, specifically cardiovascular system
Proficient use of CPT and ICD-10 codes
Excellent computer skills including Excel, Word, and Web applications
Detail oriented with above average organizational skills
Plans and prioritizes to meet deadlines
Ability to multitask and remain focused while managing a high-volume, time-sensitive workload
Equal opportunity and affirmative action employers and are looking for diversity in candidates for employment: Minority/Female/Disabled/Protected Veteran
