Prior Authorization Coordinator - Part Time

Nationwide Children's Hospital Inc; Toledo (OH); On-site; USD 25,000 - 33,000; Part time

Job summary

Nationwide Children's Hospital Inc is seeking a Prior Auth Specialist to support pre-authorization processes for exams and services across NCH facilities. Responsibilities include gathering documentation, communicating with third-party payers, and coordinating with clinics to ensure timely approvals.

The role emphasizes accurate HIS documentation, data sharing, and collaboration with Patient Accounts to resolve billing issues related to pre-authorization.

Qualifications

• High School Diploma or equivalent required.
• Associate's Degree preferred.
• 1 year of pre-registration, registration, admitting, or customer service experience preferred.
• Experience with billing processes and insurance verification desired.
• Working knowledge of HIS Work Queues.

Responsibilities

• Process pre-authorization documentation for exams/services.
• Contact third party payers to obtain pre-authorizations.
• Follow up on pending pre-authorizations and update clinics.
• Inform clinics when peer-to-peer is requested and provide details for approvals.
• Assist Patient Accounts with billing issues related to pre-authorization.

Skills

Customer service

Communication

Problem solving

Navigate complex information

Revenue cycle knowledge

Medical terminology

Team player

Adapt to change

Data entry / keyboarding

Education

High School Diploma or equivalent

Associate's Degree (preferred)

Tools

HIS Work Queues

Job description

Nationwide Children's Hospital Inc is seeking a Prior Auth Specialist to support pre-authorization processes for exams and services across NCH facilities. Responsibilities include gathering documentation, communicating with third-party payers, and coordinating with clinics to ensure timely approvals.

The role emphasizes accurate HIS documentation, data sharing, and collaboration with Patient Accounts to resolve billing issues related to pre-authorization.