Authorization Specialist (Days)

We are seeking an Authorization Specialist in the Admitting department at Riverview Regional Medical Center (Gadsden, AL), a member of Prime Healthcare. As an Authorization Specialist you will reviews databases and other pertinent documentation to ensure all needed pre-certifications and/or authorizations are completed for medical services.

Shift’s Available: Days

Employment Type: Full Time

Hours: 7:45AM - 4:15PM Monday - Friday

Here are some of the benefits of working at Prime Healthcare:

Health, dental, and vision insurance options

Paid vacation, sick time and holidays

Bereavement leave, FMLA and other leave options

Employer 401K options

Tuition reimbursement options

Life, disability, and other insurance options

Many other amazing benefits

Responsibilities

Essential Duties and Responsibilities (includes, but not limited to):

Secures insurance information, eligibility, benefits and authorizations as applicable.

Review patient information, contact payers, and ensure timely and accurate completion of authorization requests.

Requires strong customer service skills in order to answer inquiries from patients and healthcare providers.

Ability to collect copays/pre-pays.

Works closely with all facets of the Admitting department including PBX operator function and reception areas.

Must be able to operate a computer to input and retrieve data.

Ability to communicate with the population served, utilizing age specific techniques from neonatal, pediatrics, adolescents, young adults, middle adult to geriatrics.

Maintain proficiency in medical terminology.

Special projects or other assignments may be given with expectations to be completed in a specified timeframe

Qualifications

EDUCATION, EXPERIENCE, TRAINING

Knowledge of standard insurance companies and verification requirements.

Well versed in authorization processes for all payers

Knowledge of medical terminology

Basic computer skills

Knowledge of Common Procedural Terminology (CPT), ICD codes

Ability to multi-task, prioritize needs to meet required timelines

Analytical and problem-solving skills

Customer Services experience required

High School Graduate or GED Equivalent required (effective 4/1/14 for all new hires)

3-5 years pre-certification processes and medical necessity guidelines preferred

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights:

Full Time