PRIOR AUTHORIZATION SPECIALIST_

PRIOR AUTHORIZATION SPECIALISTWFH Flexible • Emmett, ID (oogle.com/maps?q=OFF-SITE+Emmett+ID+USA)ApplyDescriptionPosition Title: Prior Authorization SpecialistDepartment: Business OfficeSupervisor’s Title: HIM/Business Office ManagerIHA# Position Summary:The Prior Authorization Specialist is responsible for obtaining pre-certifications and pre-authorizations for procedures performed at Valor Health. Developing and implementing prior authorization workflow, policies, and procedures. Principal Functions and Responsibilities:+ Contact insurance carriers to verify patient’s insurance eligibility, benefits, and requirements.+ Request, follow up and secure prior authorizations prior to services being performed at Valor Health.+ Prioritize incoming authorization requests according to urgency.+ Collaborate with other departments to assist in obtaining prior authorizations in a cross-functional manner.+ When necessary, work with billing specialist to obtain a retro authorization.+ Assist with medical necessity documentation and submit medical records to expedite approvals and ensure that appropriate follow up is performed.+ Review accuracy and completeness of information requested and ensure that all supporting documents are present.+ Responsible for reviewing all encounters and mailing out Consolidated Summary of+ Attends and participates in meetings as requested.+ Performs other duties as assigned.RequirementsPosition Qualifications/Requirements/preferences:+ Minimum Education: High school diploma or equivalent.+ Minimum of 3 years’ experience working in healthcare.+ Minimum of 2 years’ experience as a Medical Assistant/CAN/LPN+ Preferred experience with obtaining prior authorizations.+ Ability to communicate effectively with a wide variety of contacts at all levels of the organization.+ Must have strong organizational skills and attention to detail.+ Strong work ethic and ability to apply critical thinking to a variety of practical and time sensitive situations.+ Working knowledge of Microsoft Office including Word, Excel, and Outlook are required.+ Consistent professionalism in both presentation and demeanor.+ Ability to work with minimal supervision and as a member of a team.+ Ability to Flex Schedule to adjust to workflow.Working Conditions:+ Primarily office work. Positions is flexible to be in suite, remote or hybrid.+ General Health care environment exposure to patient conditions.+ Physical Requirements: Standing, walking, bending, stooping, sitting, hand eye coordination, speaking.