Prior Authorization Specialist - Onsite

Description

Location: Cherry County Hospital, Valentine, NE
Position: Full-Time (40 hours/week) - Onsite
Compensation:  Starting at $21.08/hr  (Based on Experience)
Benefits: Eligible for benefits

Cherry County Hospital is seeking a dedicated and skilled Prior Authorization Specialist to join our team. In this vital role, you will be responsible for obtaining pre-certifications and pre-authorizations for medical procedures and medications at our hospital and clinic.

Duties and Responsibilities:

As a Prior Authorization Specialist, you will:

• Contact insurance carriers to verify patient insurance eligibility, benefits, and requirements
   
• Request, track, and obtain pre-authorizations for medical procedures and services
   
• Follow up with insurance carriers to ensure timely authorizations before services are performed
   
• Demonstrate a solid understanding of medical terminology and office procedures, including HIPAA regulations
   
• Communicate any insurance changes or trends to relevant departments
   
• Maintain a level of productivity suitable for the department
   
• Appeal insurance/payor denials when applicable
   
• Document all communications and contacts in a standardized format
   
• Notify department heads of any additional staffing or equipment needs
   
• Assist with occasional filing or record retrieval as needed
   
• Cooperate and work effectively with staff, public, and physicians
   
• Ensure the confidentiality of all patient medical, personal, and financial records
   
• Practice and adhere to corporate compliance policies and procedures
   
• Perform additional duties as assigned by the supervisor
   

Skills and Abilities:

• Excellent verbal and written communication skills
   
• Proficiency with computers and related software (Microsoft Excel, Word, and Windows)
   
• Strong organizational skills and the ability to interpret data
   
• Strong judgment, tact, diplomacy, and problem-solving skills
   
• Ability to work collaboratively in a team environment
   
• Strong attention to maintaining confidentiality of hospital and patient information
   
• Ability to perform repetitive tasks with minimal independent judgment
   
• Familiarity with state and federal confidentiality laws, including HIPAA, and the ability to follow policies regarding the privacy and security of health information
   

Physical Demands and Working Conditions:

• Sedentary work involving periods of sitting, talking, typing, and listening
   
• Repetitive use of hands, arms, and eyes, which may cause strain
   
• Significant manual dexterity to operate business office machines and equipment 

Comprehensive Benefit Package: 

•Health Insurance: Co-pay or HSA plan options: 100% paid for Employee 

•Dental: 100% paid for Employee 

•Vision: 100% paid for Employee 

•$50,000 Group Life Insurance with AD&D 

•Long-Term Disability: 100% paid for Employee 

•Medical and Dependent Care Flexible Spending Accounts 

•Health Savings Account with employer contribution 

•Supplemental Insurances: Short-Term Disability, Supplemental Life and AD&D, Critical Illness, Hospital Indemnity and Accident •Retirement Plan: 457 plan Pre-Tax and Roth options 
 

Why Cherry County Hospital?

• Be part of a dedicated, compassionate healthcare team
   
• Competitive pay and excellent benefits
   
• Work in a collaborative and supportive environment
   

Apply Now!
Join our team at Cherry County Hospital and contribute to the delivery of exceptional healthcare services in our community.

Requirements

• High school diploma required  
• Prior customer service experience in a medical setting preferred  
• Knowledge of medical terminology preferred  
• Previous experience with Microsoft Excel, Word, and Windows