Job Description

Black Hills Surgical Hospital has a Prior Authorization Specialist position available. This position can be done remote or onsite. Hours are Monday through Friday. The Prior Authorization Specialist is a non-clinical staff member who is part of an integrated care team that focuses on coordinating the insurance coverage aspect to patient care. Beginning with an initial evaluation of insurance eligibility the Prior Authorization Specialist will determine coverage for the treatment plan, financial liabilities, and obtain/verify any necessary prior authorizations from commercial and government health insurances. 

Specific duties:

• Ensure request for authorization is timely and handled in accordance with departmental policy and payer requirements.
• Accurately verify patient demographics, insurance eligibility, benefits, and financial responsibility.
• Build and maintain professional, cooperative relationships with all departments that have direct or indirect impact on obtaining authorizations.
• Prepare estimates for scheduled services. Must interpret patient's benefits correctly for accurate estimates.
• Clearly document all communications and contacts with payers, physicians, and families in standardized documentation requirements including proper format. Communicate effectively, timely and professionally in writing and verbally.
• Consistently demonstrates excellent, empathetic, and knowledgeable customer service skills to internal and external customers.

Skills:

• Experience in business/professional written and verbal communication.
• General understanding of medical terminology, insurance billing, or coding background desirable.
• Exceptional customer relation skills.
• Intermediate level of computer knowledge with experience in Mi

Job Tags

Full time, Remote job, Monday to Friday,

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