Full-Time Prior Authorization Representative
DEPARTMENT: PATIENT FINANCIAL SERVICES
JOB POSITION: PRIOR AUTHORIZATION REPRESENTATIVE
JOB STATUS:
FULL-TIME 80 HOURS, MONDAY – FRIDAY – 8:00AM – 4:30PM
JOB QUALIFICATIONS:
High school graduate or equivalent. Understanding of insurance billing including Medicare, Medicaid and Commercial strongly preferred. Experience in medical
terminology and medical coding a plus. Must possess excellent computer, office, and math skills and have a firm understanding of the medical billing process and Explanation of Benefits from insurances. Must be highly motivated and have the ability to perform effectively with frequent interruptions and competing demands. Must be able to communicate effectively including reading, following written and oral directions, the ability to converse well with various departments and providers. Must be capable of working well with the public on a professional and confidential basis. Must be attentive to detail and accuracy. Must work well as a team. Experience with Epic preferred.
JOB DUTIES:
Obtains prior authorization/pre-certification and completes third-party eligibility verifications for outpatient therapeutic and diagnostic procedures, surgeries, and
infusions. Maintains compliance with the payer reimbursement policies and Federal Health Care program requirements. Interacts professionally with patients, providers regarding documentation policies and procedures. Checks patient orders and compares with local and national coverage determinations for qualifying diagnosis. Answers telephone and manages messages and requests. Must be a strong communicator with a focus on confidentiality, quality of work and customer satisfaction. Willing to be cross-trained in other areas as requested. Other duties as needed.
JOB AVAILABILITY:
To be discussed with the applicant at the time of interview.
COMPENSATION:
To be discussed with the applicant at the time of interview.
CONTACT PERSON:
If interested contact Lisa Rife, Revenue Cycle Director at lrife@wyandotmemorial.org, apply online, or fax application to 419-209-0000.