Valor Health
PRIOR AUTHORIZATION SPECIALIST
Valor Health, Emmett, Idaho, United States, 83617
ApplyDescriptionPosition Title:
Prior Authorization SpecialistDepartment:
Business OfficeSupervisor’s Title:
HIM/Business Office ManagerPosition Summary:The Prior Authorization Specialist is responsible for obtaining pre-certifications and pre-authorizations for procedures performed at Valor Health. This includes 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 specialists 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.Attend and participate in meetings as requested.Perform 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/CNA/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 is 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. Position is flexible to be in suite, remote, or hybrid.General healthcare environment exposure to patient conditions.Physical Requirements:
Standing, walking, bending, stooping, sitting, hand-eye coordination, speaking.
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Prior Authorization SpecialistDepartment:
Business OfficeSupervisor’s Title:
HIM/Business Office ManagerPosition Summary:The Prior Authorization Specialist is responsible for obtaining pre-certifications and pre-authorizations for procedures performed at Valor Health. This includes 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 specialists 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.Attend and participate in meetings as requested.Perform 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/CNA/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 is 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. Position is flexible to be in suite, remote, or hybrid.General healthcare environment exposure to patient conditions.Physical Requirements:
Standing, walking, bending, stooping, sitting, hand-eye coordination, speaking.
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