Healthcare Prior Authorization Specialist - Centralized

Floyd Valley; Le Mars (IA); On-site; USD 42,000 - 56,000; Full time

Benefits offered by this job

Student Debt Program

IPERS Retirement

Medical Insurance

Dental Insurance

Vision Insurance

Flexible Spending Account (FSA)

Short-term Disability Insurance

Long-term Disability Insurance

Life Insurance

Fitness Center

Paid Time Off

Competitive pay based on experience

Job summary

Floyd Valley Healthcare in Le Mars, IA seeks a Centralized Authorization Department Representative. This full-time role manages prior authorizations for medical tests, surgeries, and procedures, communicating results to physicians, clinics, and patients.

The position uses electronic medical records to process requests and coordinates with nursing leadership on denials and appeals. Ideal candidates have ICD-10 and CPT knowledge, at least 1 year of healthcare experience, and familiarity with payer

Qualifications

• Knowledge in ICD-10 and CPT is preferred; prior authorization experience beneficial.
• Minimum of 1 year of healthcare experience.

Responsibilities

• Determine eligibility for payors by obtaining prior authorization for tests, procedures, surgeries, and LCDs.
• Document prior authorizations and communicate results to facilities, physicians, clinics, and patients or families.
• Utilize electronic medical records to process required authorizations and communicate within the organization.
• Communicate with Nurse Manager and/or RN regarding denials and appeals; assist in medical records retrieval for appeals.

Skills

ICD-10 knowledge

CPT knowledge

Prior authorization

Coding experience

General computer skills

Job description

Floyd Valley Healthcare in Le Mars, IA seeks a Centralized Authorization Department Representative. This full-time role manages prior authorizations for medical tests, surgeries, and procedures, communicating results to physicians, clinics, and patients.

The position uses electronic medical records to process requests and coordinates with nursing leadership on denials and appeals. Ideal candidates have ICD-10 and CPT knowledge, at least 1 year of healthcare experience, and familiarity with payer