Prior Authorization Specialist
Prior Authorization Specialist
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Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
Overview
Under the direct supervision of the oncology services manager performs assigned duties including telephonic support for on-line authorization of routine services contacting specialty care providers monitoring patient eligibility and performing on-line data entry of routine authorizations / denials.
Why UnityPoint Health
At UnityPoint Health you matter. Were proud to be recognized as a Top 150 Place to Work in Healthcare by Beckers Healthcare several years in a row for our commitment to our team members.
Our competitive Total Rewards program offers benefits options that align with your needs and priorities no matter what life stage youre in. Here are just a few:
- Expect paid time off parental leave 401K matching and an employee recognition program.
- Dental and health insurance paid holidays short and long-term disability and more. We even offer pet insurance for your four-legged family members.
- Early access to earned wages with Daily Pay tuition reimbursement to help further your career and adoption assistance to help you grow your family.
With a collective goal to champion a culture of belonging where everyone feels valued and respected we honor the ways people are unique and embrace what brings us together.
And we believe equipping you with support and development opportunities is a vital part of delivering an exceptional employment experience.
Find a fulfilling career and make a difference with UnityPoint Health.
Responsibilities
Establish effective rapport and work closely with QA HCC Administration Clinical Patients Families and Billing teams to ensure that all patients have authorization for services performed.
Contacts providers with authorization denial and appeals process as applicable.
Verifies eligibility and authorization needs of current patients for continued services.
Able to work from spreadsheets in determining authorization needs.
Performs telephonic and on-line authorization requests for our services.
Assists in gathering information needed for clinical staff to determine continued services.
Assists in educating and acts as a resource to clinical and non-clinical departments.
Assists with the identification and reporting of potential quality management issues.
Accurately enter required information into all applicable systems.
Proficient in the use of Diagnosis Coding HCPCS Revenue and CPT coding. Continued education on all coding.
Qualifications
Education: High School or Vocational School graduate. Strong interpersonal skills. Ability to work independently or as part of a team. Ability to understand and apply guidelines policies and procedures.
Experience: One year of billing experience is preferred. Proficient in Microsoft office software. Previous medical office experience. Familiar with billing codes i.e. HCPCS Revenue CPT Coding Diagnosis Coding etc. Proficient Diagnosis Coding /CPT Coding / HCPCS / Revenue coding. Knowledge of electronic patient record systems.
License(s)/Certification(s):Valid drivers license when driving any vehicle for work-related reasons.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
