Day-Shift Insurance Verification & Pre-Auth Specialist

Arkansas Children’s Hospital; Little Rock (AR); On-site; USD 22,000 - 28,000; Full time

Job summary

Arkansas Children’s Hospital is seeking an Outpatient Pre-Authorization Specialist to verify insurance, obtain pre-authorizations, and coordinate coverage for patients admitted to the hospital for care.

The role involves counseling families on co-pays, maintaining charge capture information, and coordinating with clinical departments to ensure smooth patient access to services. This is a full-time day-shift position based in Little Rock.

Qualifications

• No education requirements (as per job posting)
• Recommended Education: High school diploma or GED or equivalent
• Required Work Experience: Entry Level - Experience not Required.

Responsibilities

• Obtains pre-authorization approvals for outpatient procedures from the Surgery, Day Medicine, Radiology, Nuclear Medicine, Genetics, Sleep lab and Heart Station departments.
• Preregisters, obtains prior authorization, price estimates, PCP referrals, upfront collections and referred accounts prior to date of service.
• Obtains prior authorizations and insurance verification for all clinics, Medicare patients, out-of-state Medicaid, SDC and for specialty drugs.
• Obtains the appropriate prior authorizations for surgical and outpatient procedures and the necessary CPT/ICD-10 diagnosis codes when appropriate.
• Obtains price estimates, upfront collections and referred accounts prior to date of service.
• Completes outbound calls to families regarding insurance coverage and benefits, high deductibles, co-pays, denials.
• Conducts appropriate follow-ups and verifications on all assigned accounts including documenting in the patients account detailed insurance information prior to services being rendered.
• Ensures that pre-certifications, pre-notifications, prior authorizations or referrals are received for each account with a financial class of insurance and/or Medicaid.
• Appropriately refers all high dollar or self-pay accounts to Financial Counselor.
• Serves as a liaison between the clinical staff and insurance payers.
• Collects deductible, co-pay and all other applicable payments.
• Performs other duties as assigned.

Education

High school diploma or GED or equivalent

Job description

Arkansas Children’s Hospital is seeking an Outpatient Pre-Authorization Specialist to verify insurance, obtain pre-authorizations, and coordinate coverage for patients admitted to the hospital for care.

The role involves counseling families on co-pays, maintaining charge capture information, and coordinating with clinical departments to ensure smooth patient access to services. This is a full-time day-shift position based in Little Rock.