Prior Authorization Pro: Fast, Accurate Insurance Approvals

Jersey Community Hospital; Jerseyville (IL); On-site; USD 36,000 - 48,000; Full time

Benefits offered by this job

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Retirement

Paid Time Off

Tuition Reimbursement

Health Savings Account

Wellness Program

Employee Assistance Program

Job summary

Jersey Community Hospital seeks an Insurance Verification Specialist to verify patient eligibility, benefits, and authorization requirements across multiple encounters. The role requires prior authorization expertise, strong communication skills, and the ability to navigate multiple EMR systems.

You will collaborate with care teams to ensure timely approvals and accurate documentation in a fast-paced hospital setting.

Qualifications

• High school graduation or equivalency.
• Certification through NAHAM, HFMA, AHIMA and Associates Degree preferred
• Minimum of two years’ experience in a clinic/hospital billing, prior authorization, and/or insurance verification area, with demonstrated payer knowledge preferred.

Responsibilities

• Contact insurance carriers to verify patient eligibility, benefits, and authorization requirements.
• Secure prior authorizations before services are performed.
• Communicate insurance changes/trends to team and leadership.
• Document all communications/contacts with providers and personnel.
• Prioritize time-sensitive authorizations.
• Maintain proficiency in multiple EMR systems for demographics, insurance, and clinical information.
• Demonstrate proficiency in digital faxing, scanning, and instant messaging tools.
• Other roles and responsibilities as assigned.

Skills

Communication

Customer service

Follow instructions

Data interpretation

Teamwork

Computer skills

Education

High school graduate

NAHAM/HFMA/AHIMA certification

Associates degree preferred

Job description

Jersey Community Hospital seeks an Insurance Verification Specialist to verify patient eligibility, benefits, and authorization requirements across multiple encounters. The role requires prior authorization expertise, strong communication skills, and the ability to navigate multiple EMR systems.

You will collaborate with care teams to ensure timely approvals and accurate documentation in a fast-paced hospital setting.