POSITION: Dedicated Authorization Specialist

EMPLOYMENT TYPE: 1.0 FTE

WORK SCHEDULE: Days

DEPARTMENT: Business Office

Internal Posting Through: 5/10/2023

Monday through Friday
No Weekends!
Experience Pay Given
Tuition Reimbursement
401K & Health Benefits

Job Summary

This position is responsible for managing the prior authorization process according to Grand Itasca Clinic & Hospital policies and procedures. It serves as an integral part of the patient care team while acting as a liaison between patients, care givers and support staff to deliver outstanding service and optimize patient flow. This position requires utilizing reasoning skills to identify needed information to obtain prior authorizations, referrals and admission/discharge notifications.

Job Duties

Initiates prior authorizations as required by payers for any outpatient tests, outpatient treatments, inpatient admissions and appointments for insurance.
Obtains pre-certifications for all inpatient and outpatient surgeries for internal and external physicians.
Obtains pertinent information and prior authorizations for workers compensation cases.
Completes all requirements for the provision of initial care and any required insurance referrals for specialty care.
Accurately processes prior authorization requests in accordance with GICH policy and procedures
Protects and maintains confidentiality and privacy of all prior authorization and member information.
Maintains current knowledge of insurance requirements and accurately performs duties in a timely manner in the gathering of medical insurance information to enter into the EHR.
Knowledge of Release of Information protocols.
Responsible for working assigned work queues and keeping the work up to date.
Providing clinical information to insurance companies for prior authorizations.
Communication with patients, coding, patient access, business office and clinical staff to gather appropriate information needed to complete daily duties.
Ability to use web sites and technology to gather and enter appropriate information to complete assigned work.
Ability to problem solve and prioritize daily work needs.
Other responsibilities as assigned based on business needs.

Qualifications

2-3 years' experience in Financial Counseling or Patient registration or Healthcare related associates degree required.
Knowledge of insurance billing, collections and plan types.
Experience providing customer service in a health care organization.
Additional courses/experience in insurance billing, accounting and/or business administration preferred.
Maintains reliable and consistent attendance.
Demonstrated ability to follow and adhere to Grand Itasca Clinic and Hospital policies, vision, mission and values.

"We are an equal opportunity employer."

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Grand Itasca Clinic & Hospital

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Dedicated Authorization Specialist