Centralized Prior Authorization Specialist (Healthcare)

Avera Health; Le Mars (IA); On-site; USD 42,000 - 60,000; Full time

Benefits offered by this job

Student Debt Program

IPERS Retirement

Medical, Dental, and Vision insurance

Flexible Spending Account (FSA)

Short-term and Long-term Disability

Job summary

Floyd Valley Healthcare in Le Mars, IA is seeking a Centralized Authorization Department Representative to join our award-winning team. This full-time role supports prior authorizations for tests, procedures, surgeries, and coding tasks, using electronic medical records to process requests and coordinate with clinics, physicians, and patients.

Shift is day, Monday to Friday, 8:00am-4:30pm; experience with ICD-10/CPT and prior authorizations preferred.

Qualifications

• Knowledge in ICD-10 and CPT preferred; minimum 1 year healthcare experience.
• Previous prior authorization and coding experience preferred.
• General computer knowledge required.
• Mandatory Reporter training certificate a plus; certification is required as an employee.

Responsibilities

• Determine eligibility for all applicable payors by obtaining prior authorization from insurers for medical tests, procedures, surgeries and any other prior authorizations required by the patient's insurance carrier or LCD if needed.
• Appropriately document prior authorization and communicate information to performing facility, physician, clinic staff and patient or patient’s family as necessary.
• Utilize electronic medical records to efficiently process required prior authorizations and communicate with within the organization.
• Communicate with Nurse Manager and/or RN status of denials and appeals. Assist in the coordination of medical records retrieval to support appeal process.
• Hours are Monday-Friday, 8:00am-4:30pm.

Skills

ICD-10 CPT knowledge

Healthcare experience

Prior authorization

Coding experience

Computer literacy

Mandatory Reporter cert

Job description

Floyd Valley Healthcare in Le Mars, IA is seeking a Centralized Authorization Department Representative to join our award-winning team. This full-time role supports prior authorizations for tests, procedures, surgeries, and coding tasks, using electronic medical records to process requests and coordinate with clinics, physicians, and patients.

Shift is day, Monday to Friday, 8:00am-4:30pm; experience with ICD-10/CPT and prior authorizations preferred.