Prior Authorization Specialist - Onsite

Description

Location: Cherry County Hospital, Valentine, NE
Position: Full-Time (40 hours/week) – Onsite
Compensation: Competitive wage based on experience
Benefits: Eligible for benefits

Now Hiring – Prior Authorization Specialist: About the Position

Cherry County Hospital is seeking a dedicated and detail-oriented Prior Authorization Specialist to join our team. In this important role, you will be responsible for obtaining pre-certifications and pre-authorizations for medical procedures and medications at our hospital and clinic.

Duties and Responsibilities

As a Prior Authorization Specialist, you will:

• Contact insurance carriers to verify patient eligibility, benefits, and requirements. 
• Request, track, and obtain pre-authorizations for medical procedures and services. 
• Follow up with insurance carriers to ensure timely authorizations before services are performed. 
• Demonstrate knowledge of medical terminology, office procedures, and HIPAA regulations. 
• Communicate insurance changes or trends to appropriate departments. 
• Maintain a level of productivity appropriate for the department. 
• Appeal insurance/payor denials when applicable. 
• Document all communications and contacts in a standardized format. 
• Notify department heads of additional staffing or equipment needs. 
• Assist with filing and record retrieval as needed. 
• Work cooperatively and effectively with staff, physicians, and the public. 
• Maintain strict confidentiality of patient medical, personal, and financial information. 
• Follow corporate compliance policies and procedures. 
• Perform additional duties as assigned by the supervisor. 

Skills and Abilities

• Excellent verbal and written communication skills. 
• Proficiency with computers and Microsoft Excel, Word, and Windows. 
• Strong organizational skills and ability to interpret data. 
• Strong judgment, tact, diplomacy, and problem-solving skills. 
• Ability to work collaboratively in a team environment. 
• Strong attention to confidentiality of hospital and patient information. 
• Ability to perform repetitive tasks with minimal independent judgment. 
• Familiarity with state and federal confidentiality laws, including HIPAA, and the ability to follow policies regarding the privacy and security of health information. 

Physical Demands and Working Conditions

• Sedentary work involving periods of sitting, talking, typing, and listening. 
• Repetitive use of hands, arms, and eyes, which may cause strain. 
• Significant manual dexterity required to operate business office machines and equipment. 

Job Requirements

• High school diploma required. 
• Prior customer service experience in a medical setting preferred. 
• Knowledge of medical terminology preferred. 
• Previous experience with Microsoft Excel, Word, and Windows. 

Comprehensive Benefit Package

• Health Insurance: Co-pay or HSA plan options; 100% paid for employee. 
• Dental Insurance: 100% paid for employee. 
• Vision Insurance: 100% paid for employee. 
• Group Life Insurance: $50,000 with AD&D. 
• Long-Term Disability: 100% paid for employee. 
• Flexible Spending Accounts: Medical and dependent care options. 
• Health Savings Account: Includes employer contribution. 
• Supplemental Insurance: Short-Term Disability, Supplemental Life and AD&D, Critical Illness, Hospital Indemnity, and Accident. 
• Retirement Plan: 457 plan with Pre-Tax and Roth options. 

Why Cherry County Hospital?

• Be part of a dedicated and compassionate healthcare team. 
• Enjoy competitive pay and excellent benefits. 
• Work in a collaborative and supportive environment. 
• Make a meaningful contribution to healthcare in our community. 

Apply Now!

Join our team at Cherry County Hospital and help us provide exceptional healthcare services to our community.

Requirements

• High school diploma required  
• Prior customer service experience in a medical setting preferred  
• Knowledge of medical terminology preferred  
• Previous experience with Microsoft Excel, Word, and Windows