PAIN & SPINE - INSURANCE PRE-AUTHORIZATION SPECIALIST

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 is looking for an Insurance Pre-Authorization Specialist to join our team!JOB SUMMARY: Checks appointments and tasks/messages to make sure the diagnosis/documentation will support medical necessity, as per insurance company, and verify that all office visits and procedures that need preauthorization are pre-authorized. Works closely with referring offices to be used as a resource in helping them get necessary paperwork to start pre-authorizations, prove medical necessity, or to perform a retro-authorization. Works closely with co-workers and vendor representatives to get visits/procedures approved.About Mountain View:Mountain View Hospital and our 29 affiliate clinics are committed to providing compassionate, cutting edge care to our patients. We serve the entire Snake River Valley – all the way from Pocatello to Rexburg. Our medical capabilities span everything from wound care to urgent care, oncology to neurology, physical therapy to speech therapy, a Level III NICU, robust robotic surgery department and a continuously expanding rural health practice.Our work environment is mission driven, people-centric and supportive. It is what sets apart and makes people excited to come to work each day. If you are looking for a career where you can make a difference in your community, we invite you to apply.BENEFITS:Taking care for our community starts with taking care of our own team. Mountain View Hospital is proud to offer its employees competitive and comprehensive benefit packages. Benefits include:Medical, Dental and Vision InsurancePaid Time Off (vacation, holidays and sick days) and Medical Paid Time OffRetirement Plans (401K with up to 6% match)Earned Quarterly Bonus ProgramEducation Reimbursement ProgramDiscount for medically necessary procedures performed at Mountain View Hospital and Idaho Falls Community HospitalPlease note benefits are based on eligibility according to full-time, part-time or PRN status classification.About Mountain View:Mountain View Hospital and our 29 affiliate clinics are committed to providing compassionate, cutting edge care to our patients. We serve the entire Snake River Valley – all the way from Pocatello to Rexburg. Our medical capabilities span everything from wound care to urgent care, oncology to neurology, physical therapy to speech therapy, a Level III NICU, robust robotic surgery department and a continuously expanding rural health practice.Our work environment is mission driven, people-centric and supportive. It is what sets apart and makes people excited to come to work each day. If you are looking for a career where you can make a difference in your community, we invite you to apply.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.Language/Communication: Ability to communicate well with patients, co-workers and vendor representatives.Mental Capabilities: Continuously able to concentrate on fine detail with interruptions and continuously able to attend to task/function for an extended period of time. Ability to learn computer programs and input data as required.Interpersonal: Ability to work well with others.Performance: Writing skills necessary to properly submit preauthorization requests with insurance companies. Appropriate phone etiquette to properly submit preauthorization requests with insurance companies. Holds the judgment, tact and diplomacy to effectively resolve conflicts.