Healthcare Prior Authorization Specialist — Day Shift

Floyd-Valley-Healthcare; Le Mars (IA); On-site; USD 45,000 - 60,000; 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

Job summary

Floyd Valley Healthcare in Le Mars, IA is hiring a Centralized Authorization Department Representative for a full-time, 40-hour week. You will determine eligibility for payors by obtaining prior authorizations and documenting them for seamless patient care.

You will communicate with facilities, physicians, and patients, using the EMR to process authorizations and support the appeals process, including denials where applicable.

Qualifications

• Knowledge in ICD-10 and CPT is preferred with prior coding experience.
• Minimum of 1 year of healthcare experience.
• Mandatory Reporter training is a plus; certification is required as an employee.

Responsibilities

• Determine eligibility for payors by obtaining prior authorizations for tests, procedures, or surgeries.
• Document prior authorizations and communicate with facilities, physicians, clinics, and patients.
• Utilize EMR to process authorizations and communicate within the organization.
• Coordinate with Nurse Manager/RN on denials and appeals; assist in medical records retrieval for appeals.

Skills

ICD-10 knowledge

CPT knowledge

Healthcare experience

General computer knowledge

Tools

Electronic Medical Records (EMR)

Job description

Floyd Valley Healthcare in Le Mars, IA is hiring a Centralized Authorization Department Representative for a full-time, 40-hour week. You will determine eligibility for payors by obtaining prior authorizations and documenting them for seamless patient care.

You will communicate with facilities, physicians, and patients, using the EMR to process authorizations and support the appeals process, including denials where applicable.