Authorization Specialist

Park Nicollet Health Services; Saint Paul (MN); On-site; USD 42,000 - 54,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Retirement program

Time away from work

Tuition reimbursement

Employee assistance program

Onsite clinic

Job summary

Park Nicollet Health Services is seeking an Authorization Specialist to support surgical services across Park Nicollet Ambulatory Surgery Centers and Methodist Hospital. You will verify insurance eligibility, obtain prior authorizations, and document payer approvals to ensure smooth scheduling and reimbursement.

Working with the Care Team, you will gather clinical documentation, monitor payer requirements, and complete training to maintain compliance and contribute to strong cash flow and

Qualifications

• High school diploma or equivalent is required.
• Proficiency with Epic and MS Office tools.
• Strong written and verbal communication and customer service skills.

Responsibilities

• Create hospital encounters for surgical services across Park Nicollet Ambulatory Surgery Centers and Methodist Hospital.
• Complete insurance verification and obtain prior authorization approvals from payers.
• Collaborate with the Care Team to submit clinical documentation for authorization review.
• Maintain and update documentation related to payer prior-authorization requirements and training.

Education

High school diploma or equivalent

Tools

Epic

Microsoft Word

Microsoft Excel

Outlook

Job description

JOB DESCRIPTION

Park Nicollet is looking to hire an Authorization Specialist to join our team! Come join us as a Partner for Good and help us make an impact on the care and experience that our patients and their families receive every day.

Position Summary

The Authorization Specialist is responsible for creating hospital encounters for surgical services throughout Park Nicollet Ambulatory Surgery Centers and Methodist Hospital. This position is responsible for completing insurance verification, obtaining and documenting prior authorization approvals from insurance companies for procedures and hospital stays.

In collaboration with the Care Team, the Authorization Specialist will obtain and submit clinical documentation pertinent to the specific services requiring authorization for payer review.

The Authorization Specialist will maintain and update documentation as it relates to changes in payer prior-authorization, pre-certification and notification requirements by reviewing insurance payer bulletins and publications.

This position must attend continuing education classes and complete mandatory training in order to maintain department specific requirements and professional growth. Effective performance of these functions helps the organization achieve strong cash flow and maximize patient’s satisfaction.

Required Qualifications

Education, Experience or Equivalent Combination:

• High school diploma or equivalent

Knowledge, Skills, And Abilities:

• Demonstrated P/C and keyboard experience.
• Demonstrated customer service skills.
• Demonstrated written/verbal communication skills.
• Knowledge of EPIC registration and/or any electronic health record
• Ability to work cohesively and respectfully with a diverse work force and patient population.
• Ability to utilize critical thinking skills while working through complex situations
• Knowledge of patient eligibility and related systems
• General knowledge of hospital billing cycle
• Demonstrates effective time management skills and problem-solving skills
• Communicates effectively and maintains composure under stressful situations
• Ability and expectation to successfully complete a competency examination on insurance selection/process upon completion of training and annually thereafter.
• Ability and expectation to demonstrate competency on insurance selection/process on a monthly basis.
• Proficiency with Epic, personal computers with word processing, spreadsheets and email.
• Preference for experience with the Microsoft Suite (e.g. Word, Excel, Outlook).
• Working knowledge of typical office equipment is expected.

Preferred Qualifications

Education, Experience or Equivalent Combination:

• Post high school degree or certification.
• Healthcare registration experience.
• Healthcare revenue cycle experience.

Knowledge, Skills, And Abilities:

• 2 years previous healthcare experience which may include medical terminology, insurance eligibility, prior authorizations, but not limited to ICD/CPT coding experience.

Benefits

• medical insurance
• dental insurance
• a retirement program
• time away from work
• insurance options
• tuition reimbursement
• an employee assistance program
• onsite clinic
• and much more!

ABOUT US

At HealthPartners we believe in the power of good – good deeds and good people working together. As part of our team, you’ll find an inclusive environment that encourages new ways of thinking, celebrates differences, and recognizes hard work.

We’re a nonprofit, integrated health care organization, providing health insurance in six states and high-quality care at more than 90 locations, including hospitals and clinics in Minnesota and Wisconsin. We bring together research and education through HealthPartners Institute, training medical professionals across the region and conducting innovative research that improve lives around the world.

At HealthPartners, everyone is welcome, included and valued. We’re working together to increase diversity and inclusion in our workplace, advance health equity in care and coverage, and partner with the community as advocates for change.

Benefits Designed To Support Your Total Health

As a HealthPartners colleague, we’re committed to nurturing your diverse talents, valuing your dedication, and supporting your work-life balance. We offer a comprehensive range of benefits to support every aspect of your life, including health, time off, retirement planning, and continuous learning opportunities. Our goal is to help you thrive physically, mentally, emotionally, and financially, so you can continue delivering exceptional care.

Join us in our mission to improve the health and well-being of our patients, members, and communities.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant because of race, color, sex, age, national origin, religion, sexual orientation, gender identify, status as a veteran and basis of disability or any other federal, state or local protected class.