Cabinet Peaks Medical Center
Prior Authorization Specialist, Full Time
Cabinet Peaks Medical Center, Libby, Montana, United States, 59923
Cabinet Peaks Medical Center - Prior Authorization Specialist, Full Time
Location: Libby, MontanaCabinet Peaks Medical Center is seeking a team-oriented Prior Authorization Specialist to work in the Business Office!This position is responsible for obtaining prior authorizations and pre-certifications for procedures and medications as well as coordinating the scheduling and rescheduling with outpatient departments and patients.Major Job Duties & Responsibilities
Contact insurance carriers to verify patient's insurance eligibility, benefits and requirements.Request, track and obtain prior authorization from insurance carriers within time allotted for medical and services.Contact patients to gather demographic and insurance information as needed, and update patient information within the EMR as necessary.Demonstrate and apply knowledge of medical terminology, high proficiency of general medical procedures including HIPAA regulations.Work closely with other departments to gather the clinical information required by the payer to authorize services.Maintain accurate records of authorizations within the EMR.Identify patients who will need to receive Medicare Advance Beneficiary Notices of Noncoverage (ABNs) as well as other Commercial notices similar to the ABN.Work with business office staff to support appeal efforts for authorization-related denials.Comply with HIPAA regulations, as well as the organization's policies and procedures regarding patient privacy and confidentiality.Maintain professional tone at all times when communicating with patients, payer representatives and fellow coworkers.Perform other clerical duties assigned by Administration or Supervisor.Adhere to the PROMISE standards and follow the AIDET practice.Skills, Knowledge, & Abilities
Strong communication skills both verbal and written.Professional customer service skills and pleasant and courteous demeanor.Knowledge of insurances.Ability to follow directions.Ability to follow Federal/State and hospital policy and guidelines.Good judgement, tact, diplomacy, and ability to problem solve.Effective customer relation skills both internal and external.Strong organizational skills, including the ability to write and interpret notes.Strong typing skills, and basic knowledge of office machines such as phones, faxes, and copy machines.Schedule
As per the needs of the department.Educational Requirements
High School Diploma or equivalent education.Experience
Previous experience in medical setting preferred.Benefits Package Available.Cabinet Peaks Medical Center is committed to providing a safe, efficient, and productive work environment for all employees. To help ensure a safe and healthful working environment, each applicant to whom an offer of employment has been made will be required as a condition of employment to undergo a substance test. Additional pre-employment items may be required. Please contact Human Resources for details.
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Location: Libby, MontanaCabinet Peaks Medical Center is seeking a team-oriented Prior Authorization Specialist to work in the Business Office!This position is responsible for obtaining prior authorizations and pre-certifications for procedures and medications as well as coordinating the scheduling and rescheduling with outpatient departments and patients.Major Job Duties & Responsibilities
Contact insurance carriers to verify patient's insurance eligibility, benefits and requirements.Request, track and obtain prior authorization from insurance carriers within time allotted for medical and services.Contact patients to gather demographic and insurance information as needed, and update patient information within the EMR as necessary.Demonstrate and apply knowledge of medical terminology, high proficiency of general medical procedures including HIPAA regulations.Work closely with other departments to gather the clinical information required by the payer to authorize services.Maintain accurate records of authorizations within the EMR.Identify patients who will need to receive Medicare Advance Beneficiary Notices of Noncoverage (ABNs) as well as other Commercial notices similar to the ABN.Work with business office staff to support appeal efforts for authorization-related denials.Comply with HIPAA regulations, as well as the organization's policies and procedures regarding patient privacy and confidentiality.Maintain professional tone at all times when communicating with patients, payer representatives and fellow coworkers.Perform other clerical duties assigned by Administration or Supervisor.Adhere to the PROMISE standards and follow the AIDET practice.Skills, Knowledge, & Abilities
Strong communication skills both verbal and written.Professional customer service skills and pleasant and courteous demeanor.Knowledge of insurances.Ability to follow directions.Ability to follow Federal/State and hospital policy and guidelines.Good judgement, tact, diplomacy, and ability to problem solve.Effective customer relation skills both internal and external.Strong organizational skills, including the ability to write and interpret notes.Strong typing skills, and basic knowledge of office machines such as phones, faxes, and copy machines.Schedule
As per the needs of the department.Educational Requirements
High School Diploma or equivalent education.Experience
Previous experience in medical setting preferred.Benefits Package Available.Cabinet Peaks Medical Center is committed to providing a safe, efficient, and productive work environment for all employees. To help ensure a safe and healthful working environment, each applicant to whom an offer of employment has been made will be required as a condition of employment to undergo a substance test. Additional pre-employment items may be required. Please contact Human Resources for details.
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