Healthcare Registration & Preauthorization Specialist

Memorial Health; Decatur (IL); On-site; USD 22,041 - 33,062; Full time

Job summary

Memorial Health in Decatur, IL seeks a Registration Representative/Preauthorization Representative to review all inpatient and outpatient procedures and ensure insurance and clinical documentation meet requirements before service date.

You will verify payor authorizations, review physician orders, coordinate referrals, and handle scheduling and preauthorizations using EHR systems and scheduling software. High school diploma or GED and customer service experience required.

Qualifications

• High school diploma or GED required.
• Previous experience in customer service required.
• Knowledge of medical terminology preferred.
• Familiarity with medical terminology or willingness to learn.

Responsibilities

• Review payor-specific prior authorization requirements and policy changes from insurance providers.
• Serve as a liaison between hospital staff and physician offices, ensuring accurate communication of outpatient diagnostic service needs and referral information.
• Receive and coordinate pre-authorizations for all outpatient services and schedules inpatient admissions as required.
• Coordinate physician referrals on appropriate patient accounts, ensuring additional services are authorized and scheduled as needed.
• Document all relevant case information accurately using the account note function.

Skills

Medical terminology

Preauthorization processes

Payor requirements

Documentation interpretation

Organizational skills

Communication skills

EHR experience

Scheduling software

Education

High school diploma or GED

Tools

Microsoft Word

Excel

Scheduling software

Preauthorization software

Job description

Memorial Health in Decatur, IL seeks a Registration Representative/Preauthorization Representative to review all inpatient and outpatient procedures and ensure insurance and clinical documentation meet requirements before service date.

You will verify payor authorizations, review physician orders, coordinate referrals, and handle scheduling and preauthorizations using EHR systems and scheduling software. High school diploma or GED and customer service experience required.