Healthcare Prior Authorization Specialist

Marshall Health Network, Inc.; Huntington (VA); On-site; USD 21,000 - 30,000; Full time

Job summary

St. Mary's Medical Center in Huntington, VA is seeking a full-time Authorization Coordinator who will identify and capture source documentation for coding procedures, injections, tests and surgeries, and manage the prior authorization process.

You will answer inquiries from insurers, document approved CPT/diagnosis codes and dates of service, and communicate authorization details to the procedure team. A high school diploma and 1 year of billing or clinical experience are preferred.

Qualifications

• High School diploma or equivalent.
• 1 year of billing or clinical experience preferred.
• Experience with prior authorization is a plus.

Responsibilities

• Uses electronic/manual systems to collect source docs for coding procedures, injections and surgeries.
• Answers calls/inquiries from insurers to assist in prior authorization for procedures.
• Performs precertification for scheduled procedures and communicates balances to patients.
• Documents authorization details in patient records, including CPT/diagnosis codes and dates.
• Works with VA and Workers' Comp case workers to obtain authorizations and claim numbers.

Skills

Communication

Customer service

Prior authorization

Healthcare billing

Education

High School diploma or equivalent

Job description

St. Mary's Medical Center in Huntington, VA is seeking a full-time Authorization Coordinator who will identify and capture source documentation for coding procedures, injections, tests and surgeries, and manage the prior authorization process.

You will answer inquiries from insurers, document approved CPT/diagnosis codes and dates of service, and communicate authorization details to the procedure team. A high school diploma and 1 year of billing or clinical experience are preferred.