Prior Authorization Specialist

Jersey Community Hospital; Jerseyville (IL); Presencial; USD 36.000 - 48.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Retirement

Paid Time Off

Tuition Reimbursement

Health Savings Account

Wellness Program

Employee Assistance Program

Descripción de la vacante

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.

Formación

• 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.

Responsabilidades

• 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.

Conocimientos

Communication

Customer service

Follow instructions

Data interpretation

Teamwork

Computer skills

Educación

High school graduate

NAHAM/HFMA/AHIMA certification

Associates degree preferred

Descripción del empleo

Description

• Contact insurance carriers to verify patient's insurance eligibility, benefits, and authorization requirement.
• Secure prior authorizations before services are performed.
• Communicate insurance changes/trends to team and leadership.
• Document all communications/contacts with providers and other 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 communication tools.
• Other roles and responsibilities as assigned.

Requirements

Education and Experience:

• High school graduate 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, w/demonstrated payer knowledge preferred.

Skills/Abilities:

• Demonstrated communication and customer service skills.
• Ability to follow oral or written instructions.
• Ability to organize and interpret data; judgment, tact, diplomacy and the ability to problem solve.
• Work effectively in a team environment; communicate with a variety of professionals
• Knowledge of computers and software required

Physical Requirements:

• Work is of light demand.

Benefits:

• Health Insurance
• Dental Insurance
• Vision Insurance
• Life Insurance
• Retirement
• Paid Time Off
• Tuition Reimbursement
• Health Savings Account
• Wellness Program
• Employee Assistance Program