What are the responsibilities and job description for the Prior Authorizations Specialist position at FOUNDATION HEALTH SERVICES?
Overview
This position is responsible for scheduling patient treatments or diagnostic procedures for assigned area. Activities include pre-registration; receiving physician orders, insurance verification, gathering preauthorizations and pre-certifications. Maintains records and produces statistical reports as required. May distribute educational materials to patients and families if needed in assigned department.
About Fairbanks Memorial Hospital Fairbanks Memorial Hospital is a non-profit facility owned by the Greater Fairbanks Community Hospital Foundation. A Joint Commission-accredited facility with 152 licensed beds, Fairbanks Memorial Hospital is the primary referral center for residents of Alaska's interior with a strong patient-to-nurse ratio and Shared Leadership Infrastructure. In addition to our exceptional clinical environment, our location offers incomparable lifestyle rewards away from work. In Fairbanks, small-town living, spectacular natural beauty and endless recreation combine to create a one-of-a-kind place to live, work and play.
Responsibilities
- Receives physician orders and seeks clarification, if necessary. Verifies insurance, obtains preauthorizations and per-certifications. Answers all telephone inquiries related to scheduling.
- Schedules patients for treatments or diagnostic procedures using computerized scheduling systems. Resolves scheduling conflicts, as needed. Documents all information regarding patient re-schedules.
- Enters patient information in computerized scheduling system and gathers information and modifies records, as needed to maintain current database. Prepares charts and manages files within regulatory requirements. Compiles and reports statistical data, if needed by the assigned department.
- Distributes educational materials to patients and families, when necessary. Responds to diverse questions or refers to appropriate clinical staff.
- Provides administrative support to the assigned unit when required.
Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards. Provides all customers of Foundation Health with an excellent service experience by consistently demonstrating our core and leader behaviors each and every day.
Qualifications
High school diploma / GED or equivalent working knowledge.The position also requires skills and abilities typically attained with 2 years of medical clerical experience; preferably in a hospital central scheduling or physician office scheduling setting. Medical terminology is required. Must possess excellent organizational skills, as well as effective human relations and communication skills.Must be proficient with commonly used office software and computers and possess the ability to use computerized scheduling systems. Must be able to maintain accurate statistical records, gather data, and produce reports. PREFERRED QUALIFICATIONS Additional related education and / or experience preferred.
Foundation Health Partners is an EEO / AAP employer; q qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status.
