Care Access & Prior Authorization Specialist

Hutchinson Clinic P A; Wichita (KS); On-site; USD 40,000 - 60,000; Full time

Job summary

Hutchinson Clinic P A is seeking a Prior Authorization Specialist in Wichita, KS to obtain prior authorizations and predeterminations for inpatient and outpatient services. The role involves collecting patient demographics, insurance and clinical information to ensure reimbursement requirements are met.

Essential duties include researching information for referrals, understanding payer requirements, and coordinating with providers and Patient Financial Services as needed.

Qualifications

• High School Diploma or GED required; medical terminology knowledge helpful.
• Strong interpersonal and verbal/written communication skills.
• Familiarity with EMR systems preferred; willingness to learn.

Responsibilities

• Research information to complete referral/precertification processes.
• Serve as the primary resource on prior authorization requirements.
• Collect and review clinical data and codes for authorizations.
• Contact payers to obtain prior authorizations and enter data into practice management system.
• Verify insurance requirements for procedures and assist billing staff as needed.
• Educate providers on the prior authorization process.

Skills

Communication skills

EMR knowledge

Interpersonal skills

Education

High School Diploma or GED

Tools

EMR system

Job description

Hutchinson Clinic P A is seeking a Prior Authorization Specialist in Wichita, KS to obtain prior authorizations and predeterminations for inpatient and outpatient services. The role involves collecting patient demographics, insurance and clinical information to ensure reimbursement requirements are met.

Essential duties include researching information for referrals, understanding payer requirements, and coordinating with providers and Patient Financial Services as needed.