Nemours Children's Health
Hospital Authorization Specialist
Nemours Children's Health, Wilmington, Delaware, us, 19894
Job Description
Nemours is seeking a Hospital Authorization Specialist to join our team.
Remote, must be in driving distance to the Main Hospital in Wilmington, DE should there be a need for an occasion to report to the office
Essential FunctionsEnsure request for authorization is timely and handled in accordance with departmental policy and payer requirements.Accurately verify patient demographics, insurance eligibility, benefits, and financial responsibility.Ability of request and obtain preauthorization for assigned specialties and be able to cover for other specialties including workqueues, preadmissions, estimates, etc.Build and maintain professional, cooperative relationships with all departments that have direct or indirect impact on obtaining authorizations.Contact families in person or by phone contact to obtain necessary information and assist them with insurance issues and/or handle direct PA and DE Medicaid newborn enrollment.Prepare estimates for scheduled services. Must interpret patient's benefits correctly for accurate estimates.Clearly document all communications and contacts with payers, physicians, and families in standardized documentation requirements including proper format. Communicate effectively, timely and professionally in writing and verbally.Consistently demonstrates excellent, empathetic, and knowledgeable customer service skills to internal and external customersCollaborates with Financial Services for newborn enrollment, Medicaid enrollment/re-enrollment, self-pay referrals, estimates and Nemours funding.Follow all newly implemented workflows including those developed by Continuous Improvement projects. Participation in CI projects may be required as Supervisor/Manager determines.Additional Requirements
Authorization experience required.High School Diploma required. Specialized (1 year of training beyond high school)Minimum 6 months of experience required.Nemours Children's Health offers a comprehensive and competitive benefit package which includes:
Medical/Dental/Vision InsuranceTuition Reimbursement/Continuing Education Support403(b) Retirement PlanPaid Time Off (PTO), VTO (Volunteer Time Off) and 6 paid holidaysProfessional/Clinical growth opportunitiesWork Life Benefits
About Us
As one of the nation's premier pediatric health care systems, we've made a promise to do whatever it takes to prevent and treat even the most disabling childhood conditions. It's a promise that extends beyond our nationally recognized clinical treatment to an entire integrated spectrum of research, advocacy, education, and prevention.
Equity, diversity, and inclusion guide our growth and strategy. We are looking for individuals who are passionate about, and committed to, leading efforts to provide culturally relevant care, reducing health disparities, and helping build a diverse and inclusive environment. All Nemours Associates are expected to ensure that these philosophies are embedded in their day-to-day work with colleagues, patients and families.
Nemours aspires to have its workforce and providers reflect the rich diversity of the communities we serve. Candidates of diverse backgrounds, race and ethnicity, religion, age, gender, sexual orientation, and those committed to working with diverse populations and conversant in multicultural values are strongly encouraged to apply. Please click here to review Nemours Anti-Racism Statement (nemours.org).
To learn more about Nemours and our commitment to treat every child as if they were our own, visit us at www.nemours.org.
Nemours is seeking a Hospital Authorization Specialist to join our team.
Remote, must be in driving distance to the Main Hospital in Wilmington, DE should there be a need for an occasion to report to the office
Essential FunctionsEnsure request for authorization is timely and handled in accordance with departmental policy and payer requirements.Accurately verify patient demographics, insurance eligibility, benefits, and financial responsibility.Ability of request and obtain preauthorization for assigned specialties and be able to cover for other specialties including workqueues, preadmissions, estimates, etc.Build and maintain professional, cooperative relationships with all departments that have direct or indirect impact on obtaining authorizations.Contact families in person or by phone contact to obtain necessary information and assist them with insurance issues and/or handle direct PA and DE Medicaid newborn enrollment.Prepare estimates for scheduled services. Must interpret patient's benefits correctly for accurate estimates.Clearly document all communications and contacts with payers, physicians, and families in standardized documentation requirements including proper format. Communicate effectively, timely and professionally in writing and verbally.Consistently demonstrates excellent, empathetic, and knowledgeable customer service skills to internal and external customersCollaborates with Financial Services for newborn enrollment, Medicaid enrollment/re-enrollment, self-pay referrals, estimates and Nemours funding.Follow all newly implemented workflows including those developed by Continuous Improvement projects. Participation in CI projects may be required as Supervisor/Manager determines.Additional Requirements
Authorization experience required.High School Diploma required. Specialized (1 year of training beyond high school)Minimum 6 months of experience required.Nemours Children's Health offers a comprehensive and competitive benefit package which includes:
Medical/Dental/Vision InsuranceTuition Reimbursement/Continuing Education Support403(b) Retirement PlanPaid Time Off (PTO), VTO (Volunteer Time Off) and 6 paid holidaysProfessional/Clinical growth opportunitiesWork Life Benefits
About Us
As one of the nation's premier pediatric health care systems, we've made a promise to do whatever it takes to prevent and treat even the most disabling childhood conditions. It's a promise that extends beyond our nationally recognized clinical treatment to an entire integrated spectrum of research, advocacy, education, and prevention.
Equity, diversity, and inclusion guide our growth and strategy. We are looking for individuals who are passionate about, and committed to, leading efforts to provide culturally relevant care, reducing health disparities, and helping build a diverse and inclusive environment. All Nemours Associates are expected to ensure that these philosophies are embedded in their day-to-day work with colleagues, patients and families.
Nemours aspires to have its workforce and providers reflect the rich diversity of the communities we serve. Candidates of diverse backgrounds, race and ethnicity, religion, age, gender, sexual orientation, and those committed to working with diverse populations and conversant in multicultural values are strongly encouraged to apply. Please click here to review Nemours Anti-Racism Statement (nemours.org).
To learn more about Nemours and our commitment to treat every child as if they were our own, visit us at www.nemours.org.