Medical Pre-Auth & Patient Access Specialist

USA Health Systems; Mobile (AL); On-site; USD 38,000 - 58,000; Full time

Job summary

USA Health in Mobile, AL is seeking an Insurance Verification Specialist to support hospital operations and ensure timely authorization submissions. The role requires a High School Diploma or equivalent and 2 years of insurance verification or precertification experience in a medical setting.

Applicants will interact with EMR systems, payer portals, and internal teams to maintain accurate documentation and prompt responses while following compliance standards and ensuring patient access to

Qualifications

• High School Diploma or equivalent with 2 years insurance verification and/or precertification experience in medical settings (required).
• Comparable combination of education and experience may substitute for the above requirements.

Responsibilities

• Abides by and enforces all compliance requirements and policies.
• Adheres to hospital policies including confidentiality.
• Requires minimal supervision to safely perform essential functions.
• Utilizes proper body mechanics when moving equipment and supplies that are necessary to perform essential functions.
• Reports broken or malfunctioning equipment to supervisor or manager.
• Initiates requests, follows up to provide additionally required information, tracks progress, expedites responses from insurance carriers and other payers, and maintains contact with patients, departments and providers to keep them continuously informed.
• Interacts with EMR systems and portals to submit authorization requests electronically to receive timely responses.
• Participates in regular group discussions regarding effectiveness of service by reviewing results, including any denials for reason under the purview of this position.
• Participates in work-group discussions and on committees as assigned.
• Participates in Performance Improvement activities as assigned.
• Completes all mandatory department, educational and hospital requirements.
• Adheres to current Infection Control and Safety Standards.
• Regular and prompt attendance.
• Ability to work schedule as defined and overtime as required.
• Related duties as assigned.

Skills

Insurance verification

Education

High School Diploma or equivalent

Job description

USA Health in Mobile, AL is seeking an Insurance Verification Specialist to support hospital operations and ensure timely authorization submissions. The role requires a High School Diploma or equivalent and 2 years of insurance verification or precertification experience in a medical setting.

Applicants will interact with EMR systems, payer portals, and internal teams to maintain accurate documentation and prompt responses while following compliance standards and ensuring patient access to