Prior Authorization Specialist

MaineHealth; Conway (NH, AR); On-site; USD 40,000 - 65,000; Full time

Job summary

An established industry player is seeking a Prior Authorization Specialist to join their dedicated team. This role involves verifying insurance eligibility, benefits, and authorization while researching denied services to ensure timely payment processing. You'll collaborate with healthcare professionals committed to delivering top-quality care, all within a supportive environment that values both colleagues and community. The organization offers a range of benefits, including flexible work policies and well-being resources, making it an ideal place for those looking to grow their careers in healthcare.

Benefits

Paid parental leave

Flexible work policies

Student loan assistance

Training and education resources

Well-being resources

Qualifications

• Experience as a Medical Assistant, Patient Service Representative, or in medical billing.
• Knowledge of insurance eligibility and benefits verification.

Responsibilities

• Verify insurance eligibility, benefits, and authorization.
• Research denied services to ensure timely payment processing.

Skills

Medical Terminology

Knowledge of Medical Insurance

Understanding of referrals/pre-authorizations

Education

High school diploma or GED

Job description

Description

Memorial Hospital

Clerical/Administrative Support
Req #: 32159

Summary:
The Prior Authorization Specialist verifies insurance eligibility, benefits, and authorization, and researches denied services to ensure timely payment processing.

Required Minimum Knowledge, Skills, and Abilities (KSAs):

1. Education: High school diploma or GED preferred.
2. License/Certifications: N/A
3. Experience: Medical Assistant, Patient Service Representative, or medical billing experience required.
4. Additional Skills/Requirements: N/A
5. Preferred Skills: Medical Terminology, knowledge of Medical Insurance, and understanding of referrals/pre-authorizations.

Additional Information:

With a career at any of the MaineHealth locations across Maine and New Hampshire, you'll work with healthcare professionals who value both their colleagues and the communities they serve.

We offer benefits supporting your current needs and future planning, including paid parental leave, flexible work policies, student loan assistance, training, education, and well-being resources for you and your family.

MaineHealth is committed to investing in our care team and fostering an inclusive environment where you can thrive and reach your full potential. If you're interested in building a career in a supportive environment dedicated to delivering top-quality care, apply today.

If you have questions about this role, please contact Connor H. Lemay at [e-mail]