Insurance Authorization Specialist

JOB DESCRIPTION SUMMARY

Compiles and maintains records of business transactions and office activities of establishment by performing the following duties.

ESSENTIAL JOB FUNCTIONS/RESPONSIBILITIES

1. Contacts insurance company/case managers to verify patient coverage and obtain information concerning the extent of benefits. Obtains prior authorization for services/visits on all new admissions and recertification’s, as required.

2. Prepares insurance verification form with data such as names of insurance company and policy holder and policy number. Accurately enters insurance information into the HCHB system.

3. Prepares an estimate of patient copayment for nurse to deliver to patient, and notifies clinician of preauthorized visits.

4. Enters visit authorizations into HCHB computer system and maintains an audit system for additional visit authorization needs. Reports unauthorized visits to supervisor when applicable.

5. Other duties as assigned by supervisor.

The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.

POSITION QUALIFICATIONS

1. One year certificate from college or technical school; or three to six months related experience and /or training; or equivalent combination of education and experience.

2. Ability to read and comprehend instructions, correspondence, and memos. Ability to develop simple forms and write correspondence.

3. Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent

4. Ability to apply common sense understanding to carry out instructions furnished in written or oral form. Ability to problem solve.

5. Must be comfortable with computer technology and have knowledge of internet software; clinical documentation software and word processing software.

6. Must be knowledgeable of medical terminology.

SKILLS REQUIRED

1. Organization

2. Detailed oriented

Physical Requirements & Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. May be required to alternately sit, stand, walk, stoop, or bend.

2. Work is performed primarily indoors, sitting.

3. Noise level is moderate.

Job Type: Full-time

Pay: $23.00 - $25.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Experience:

• Insurance verification: 1 year (Required)
• Home health: 1 year (Preferred)
• Hospice: 1 year (Preferred)

Ability to Commute:

• Emmett, ID 83617 (Required)

Ability to Relocate:

• Emmett, ID 83617: Relocate before starting work (Required)

Work Location: In person

Salary : $23 - $25