Prior Authorization Specialist

Overview

Title: Prior Authorization Specialist

Full Time, Day Shift    Schedule: 8 hour shift

Pay: $20.50 to $26.92

 

Central Maine Healthcare (CMH), a member of Prime Healthcare Foundation, is an integrated healthcare delivery system serving approximately 400,000 residents across central, western, and midcoast Maine through a network of more than 40 primary and specialty care locations. The system includes Central Maine Medical Center  (CMMC) in Lewiston, a 250-bed, not-for-profit regional referral hospital that is home to the region's only Cancer Care Center, an orthopedic ambulatory surgery center, and the Central Maine Heart and Vascular Institute. CMMC also serves as the central Maine base for LifeFlight of Maine, the state's only medical helicopter service.

 

CMH also includes Bridgton Hospital and Rumford Hospital, two 25-bed critical access hospitals that provide essential care to Maine's rural communities.

 

As part of its commitment to healthcare education and workforce development, CMH is home to the Maine College of Health Professions, Maine's first nursing and medical imaging school. The private, not-for-profit institution is accredited by the New England Commission of Higher Education and plays an important role in training the next generation of healthcare professionals.

 

To learn more, visit www.cmhc.org.

Responsibilities

The Prior Authorization Specialist position in Patient Financial Clearance is responsible for obtaining prior authorizations for diagnostic testing and procedures in accordance with payer guidelines. Job responsibilities include communicating with insurance companies to obtain approvals, collaborating with provider practices to gather necessary clinical documentation, tracking and follow up on pending authorizations to ensure timely completion and maintaining accurate documentation in the electronic health record.

Qualifications

EDUCATION, EXPERIENCE, TRAINING

 

1.      Previous experience in prior authorizations or related healthcare administraive role.

2.      Knowledge of medical terminology preferred.

3.      Effective written and verbal communication skills

4.      Ability to multi-task, prioritize needs to meet required timelines

5.      Analytical and problem-solving skills

6.      Customer Services experience required

7.      High School Graduate or GED Equivalent  Required (effective 4/1/14 for all new hires)

Pay Transparency

Central Maine Healthcare Corporation offers competitive compensation and a reasonable compensation estimate for this role is $20.50 to $26.92. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

The company is dedicated to empowering its staff with a comprehensive, competitive benefits package, allowing them the freedom to customize their benefits to fit their unique needs. Our abundant resources, programs, and voluntary options serve as a foundation for individual growth and well-being. Learn more here: https://www.primehealthcare.com/benefitsthatmattermost/

Employment Status

Full Time

Shift

Days

Equal Employment Opportunity

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf