Prior Authorization Specialist

Three Crosses Regional Hospital; Las Cruces (NM); Presencial; USD 21.000 - 30.000; Jornada completa

Descripción de la vacante

Three Crosses Regional Hospital is seeking a dedicated Prior Authorization Clerk to ensure accurate patient registration and timely information collection. You will verify insurance eligibility, review deductibles, and collaborate with schedulers to resolve discrepancies while maintaining HIPAA compliance.

The role emphasizes teamwork, confidentiality, and supporting a patient-centered culture within the hospital environment.

Formación

• Requires high school diploma or equivalent.
• Preferred: 1 year of hospital customer service experience.

Responsabilidades

• Maintain patient demographic information and data collection systems.
• Verify insurance eligibility for upcoming appointments using online portals or carrier contacts.
• Review patient deductibles and/or copays and record in EHR and front-end spreadsheets.
• Coordinate with schedulers on discrepancies.
• Assist front-end staff in understanding carrier websites and eligibility verification.
• Enter insurance correspondences as needed.
• Contribute to development and update of SOPs and manuals.
• Answer questions from patients, clerical staff, and insurers.
• Work with schedulers and financial counselors to ensure clean billing.
• Attend staff meetings and engage in continuous education.

Conocimientos

Customer service

Team collaboration

HIPAA compliance

Educación

High School Diploma or equivalent

Herramientas

Electronic Health Record (EHR)

Descripción del empleo

Three Crosses Regional Hospital is seeking a dedicated Prior Authorization Clerk to ensure accurate patient registration and timely information collection. You will verify insurance eligibility, review deductibles, and collaborate with schedulers to resolve discrepancies while maintaining HIPAA compliance.

The role emphasizes teamwork, confidentiality, and supporting a patient-centered culture within the hospital environment.