What are the responsibilities and job description for the Prior Authorization Specialist position at Salem Regional Medical Center?
SCH Professional Corporation Has an Exciting Opportunity for Qualified Candidates!
Position: Full Time Prior Authorization Specialist
Department: PC Patient Access
Shift: Days M-F
PURPOSE
The primary purpose of the Prior Authorization specialist is to communicate with the clinical staff, surgical schedulers, providers, and insurance companies to obtain authorizations and coordinate scheduling for upcoming procedures and/or surgeries for Firestone Ambulatory Surgery Center. This individual will work with various insurance companies to obtain eligibility, verify coverage of services to be performed and obtain pre-certifications for procedures/surgeries ordered.
This individual will perform assigned duties in an efficient manner, in accordance with established procedures, and as directed by the manager of SCH Professional Corporation Revenue Cycle to assure that a successful, viable department is always maintained. The Prior Authorization Specialist is responsible for gathering appropriate information during the scheduling process, accurately and timely calling insurance companies for verification including benefit details, referral information, precertification/authorization, and determining patient financial responsibilities along with scheduling patients on the ASC scheduling system. This individual will work closely with the physician offices to ensure that proper information is obtained and processed in an efficient timely manner. This individual will also assist the physician offices and patients with any questions and concerns. This individual will perform these duties in a courteous and professional manner.
This position will also require the employee to perform other related duties and activities assigned by your Director or Manager of the department.
QUALIFICATIONS
· High School Diploma required
· Medical terminology knowledge
- Must have experience with clerical/office work.
- Must have knowledge of insurance company procedures.
- Strong phone and written communication skills
- Customer Service
- Ability to work well with co-workers and work as a team
- Computer skills: Typing, Microsoft Word, Excel
- Be able to make a change on demand and a multitasker
BENEFITS
- Competitive Wages
- Medical/prescription insurance
- Dental insurance
- Vision insurance
- Accident and critical insurances
- 403 (b) retirement with employer matching
- Cafeteria discounts
- Employee Assistance Program
