Medical Pre-Authorization Navigator

Mountain-View-Hospital-LLC; Idaho Falls (ID); On-site; USD 38,000 - 48,000; Full time

Benefits offered by this job

Medical/Dental/Vision

Paid Time Off

401K with match

Quarterly Bonus

Education Reimbursement

Discount on procedures

Job summary

Mountain View Hospital in Idaho Falls is seeking an Insurance Pre-Authorization Specialist to join our team. You will verify medical necessity for visits and procedures, check diagnoses and CPT codes, and ensure preauthorizations are completed timely.

You will collaborate with referring offices and vendor representatives to obtain paperwork and approvals, support billing, and maintain accurate records while delivering compassionate patient service.

Qualifications

• Education: High School graduate or equivalent.
• Knowledge of diagnoses and CPT codes for pain management services preferred.
• Experience: Prior experience with coding and billing for outpatient billing is preferred.
• Ability to communicate well with patients, co-workers and vendor representatives.
• Performance: Writing skills to properly submit preauthorization requests with insurance companies; appropriate phone etiquette.

Responsibilities

• Check appointments and tasks/messages to verify that the diagnosis/documentation supports medical necessity and preauthorization.
• Verify that all office visits and procedures requiring preauthorization are preauthorized.
• Collaborate with referring offices to obtain necessary paperwork to start preauthorizations or retro-authorizations.
• Work with co-workers and vendor representatives to obtain visits/procedures approvals.

Skills

Attention to detail

Communication

Written communication

Education

High School diploma or equivalent

Job description

Mountain View Hospital in Idaho Falls is seeking an Insurance Pre-Authorization Specialist to join our team. You will verify medical necessity for visits and procedures, check diagnoses and CPT codes, and ensure preauthorizations are completed timely.

You will collaborate with referring offices and vendor representatives to obtain paperwork and approvals, support billing, and maintain accurate records while delivering compassionate patient service.