What are the responsibilities and job description for the Prior Authorization Specialist position at Madison County Hospital?
Are all hospitals the same? Not on your life. Hospitals are as different as the people who work in them. At Madison Health, our staff members know that kindness and compassion have a healing power all their own. They recognize that they each play a special role in creating a caring environment for our patients.
We are always looking for caring healthcare professionals to join our family of caregivers. Our associates are empowered to help improve the lives of others and the quality of care our patients receive.
What we offer:
- Competitive compensation and benefits packages including medical, dental and vision coverage
- Paid Time Off
- Tuition/Professional Development reimbursement
- Hospital paid life insurance, short and long-term disability insurance
- Retirement savings account with employer match
- Employee wellness program
Why London, Ohio?
London is a growing community just 25 minutes west of Columbus, OH. London offers a small town feel while still being close to metropolitan areas where you have easy access to a blend of entertainment and cultural experiences.
Primary Job Functions:
- Verifies insurance eligibility and obtains authorization from insurance companies for surgical procedures to be performed at Madison Health. Follows up with insurance companies for status updates of authorization requests and provides additional documentation as necessary. Maintains documentation of authorization in EMR.
- Interacts with physicians’ offices to complete authorizations. Receives and answers calls from physician offices regarding authorization needs. Requests clinical documentation from physician offices to obtain authorizations. Refers denials of authorization back to physician offices for peer-to-peer review.
- Appeals denied claims for authorization related issues. Follows up on appeals and documents in EMR.
- Provides coverage for referrals and phone room in Specialty Care as required.
- Treats patients, physicians and physician office staff with dignity and respect. Ensures confidentiality of patient records. Interacts professionally with patients and families and provides explanations and verbal reassurance as necessary.
This is a Monday-Friday, Day Shift position
Minimum Qualifications:
Education:
High School Diploma or equivalent preferred.
