Bitterroothealth
Prior Authorization Specialist (080224.3) FULL TIME
Bitterroothealth, Hamilton, Montana, United States, 59840
Prior Authorization Specialist (080224.3) FULL TIME
Job Description
Posted Friday, August 2, 2024 at 8:00 AMBITTERROOT'S BEST EMPLOYER 2022 & 2023State of Montana "EMPLOYER OF CHOICE" 2022Prior Authorization opportunity in beautiful Hamilton, Montana!Bitterroot Health is seeking candidates to fill a Prior Authorization position. The Pre-Authorization incumbent ensures that payers are prepared to reimburse Bitterroot Health for scheduled services in accordance with the payer-provider contract, and works diligently toward the identification, mitigation, and prevention of clinical denials. In addition to contacting payers and providers to secure authorizations, this staff member communicates to the clinical team while reviewing initial clinical denials to determine next steps. Additionally, they conduct appeals as appropriate by reviewing medical necessity, responding to authorization concerns, and/or reconciling coverage-related issues.Minimum Qualifications:Education:
High School Diploma, General equivalency diploma (GED).Job Knowledge/Skills/Abilities:
Courses in medical terminology beneficial; at least three years hospital or healthcare experience in revenue cycle preferred; at least three years of experience preferred in one of the following areas: denials, billing, prior authorization, patient access.Schedule:
Full-time, 40 hours/weekBenefits:
This position is eligible for the full benefit package.Bitterroot Health is a great place to work! We were named “Bitterroot’s Best Employer" in 2022 & 2023. We were also selected among Montana’s large companies as the 2022 “Employer of Choice” for the state of Montana.
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Job Description
Posted Friday, August 2, 2024 at 8:00 AMBITTERROOT'S BEST EMPLOYER 2022 & 2023State of Montana "EMPLOYER OF CHOICE" 2022Prior Authorization opportunity in beautiful Hamilton, Montana!Bitterroot Health is seeking candidates to fill a Prior Authorization position. The Pre-Authorization incumbent ensures that payers are prepared to reimburse Bitterroot Health for scheduled services in accordance with the payer-provider contract, and works diligently toward the identification, mitigation, and prevention of clinical denials. In addition to contacting payers and providers to secure authorizations, this staff member communicates to the clinical team while reviewing initial clinical denials to determine next steps. Additionally, they conduct appeals as appropriate by reviewing medical necessity, responding to authorization concerns, and/or reconciling coverage-related issues.Minimum Qualifications:Education:
High School Diploma, General equivalency diploma (GED).Job Knowledge/Skills/Abilities:
Courses in medical terminology beneficial; at least three years hospital or healthcare experience in revenue cycle preferred; at least three years of experience preferred in one of the following areas: denials, billing, prior authorization, patient access.Schedule:
Full-time, 40 hours/weekBenefits:
This position is eligible for the full benefit package.Bitterroot Health is a great place to work! We were named “Bitterroot’s Best Employer" in 2022 & 2023. We were also selected among Montana’s large companies as the 2022 “Employer of Choice” for the state of Montana.
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