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Prior Authorization Specialist - hybrid after onsite training! - Full Time 8am-4:30pm
Job Ref: 29384Category: Clerical & Administrative Support
Location:
Emerson Hospital,
133 Old Road to Nine Acre Corner,
Concord,
MA 01742
Department: Patient Access
Schedule: Full Time
Shift: Day shift
Hours: 8:00-4:30
Job Summary
Reports to the Direct of Patient Access, the position serves as the hospital`s primary contact for patient reimbursement issues in accordance with established credit policies. The position works with third-party payors for necessary authorizations and verification of coverage issues. The position also provides cashiering services for Emerson Hospital.
Minimum Qualifications
- Education
- High School Diploma or equivalent required.
- Associates Degree preferred.
- Work experience may be substituted for higher education.
- Experience
- One to 3 years as a financial counselor at a hospital and/or authorization coordinator required
and/or
3-5 years full-time admitting experience with insurance knowledge required - Knowledge of insurances, pre certification and referral procedures required
- Knowledge of the Virtual Gateway and Medicaid applications preferred
- Experience in working with patients required
- Experience in working with payers to appeal pre auth denials preferred
- Licensure and/or Certification
- None required
- Skills
- Knowledge of third party payors.
- Knowledge of Medicare billing practices and regulations.
- Insurance verifications experience.
- Computer proficiency.
- Excellent interpersonal skills are required to interact effectively with all organizational levels, with demonstrated organizational skills and ability to work accurately with detailed confidential information.
- Must have the ability to read, write and communicate in English.
- Must be highly organized, cooperative, and able to work well with others.
- Ability to prioritize and perform multiple tasks.
- Thorough understanding of team management concepts.
- Comprehensive knowledge of medical terminology.
- The ability to effectively communicate with external organizations as well as various levels of management required.