Prior Authorization Specialist

Singing River Hospital; Pascagoula (MS); On-site; USD 40,000 - 70,000; Full time

Job summary

An established healthcare provider is seeking a dedicated Prior Authorization Specialist to ensure compliance with authorization requirements for various medical services. This role involves evaluating requests for diagnostic imaging, radiation therapy, and more, ensuring that all processes align with healthcare guidelines. The ideal candidate will possess strong communication skills and the ability to work under pressure while maintaining attention to detail. Join a dynamic team that values superior customer service and offers opportunities for professional growth in a supportive environment.

Qualifications

• High School diploma required; Associate's or Bachelor's preferred.
• Certification as a Prior Authorization Specialist preferred.

Responsibilities

• Evaluate medical services for authorization requirements.
• Obtain authorization for diagnostic imaging and other services.

Skills

Customer Service Skills

Communication Abilities

Decision-Making Skills

Attention to Detail

Multitasking

Education

High School Diploma

Associate's Degree in Business

Bachelor's Degree in Healthcare Administration

Tools

EMR Systems

Office Technology

Job description

Prior Authorization Specialist

Location: Financial Services Building - Pascagoula

Position Type: Full-Time

Schedule: Monday - Friday, 08:00am - 4:30pm

Address: 2809 Denny Avenue, Pascagoula, Mississippi, 39581, United States

Position Overview

The Authorization Specialist evaluates medical services ordered for authorization requirements with payers and obtains authorization for diagnostic imaging, radiation therapy, oncology, rheumatology, and other services necessary for reimbursement.

All duties are expected to comply with Singing River Health System procedures, policies, accreditation standards, and governing healthcare guidelines.

Disclaimer

This list of responsibilities, duties, skills, efforts, requirements, or working conditions is not exhaustive. Management reserves the right to revise the job or assign other tasks as needed.

Qualifications

• Education: High School diploma or equivalent required; Associate’s or bachelor’s degree in business, finance, healthcare administration, or related field preferred.
• License: N/A
• Certifications: Certification as a Prior Authorization Certified Specialist through the National Board of Prior Authorization Specialists preferred.

De-escalation training must be completed within 90 days of employment.

Experience

Experience in a hospital or physician office setting obtaining authorizations for diagnostic imaging or medical oncology services is preferred.

Reports To

Patient Access Services Manager

Supervises

N/A

Physical Demands

Moderately active work involving sitting, moving about the office and facility, and occasional travel within the SRHS service area. Tasks include exerting minimal force to move objects and exposure to body fluids and tissues. Repetitive motions include operating office equipment. Visual and auditory acuity are required, along with the ability to work extended periods without fatigue. Schedule flexibility is necessary.

Mental Demands

Requires keen assessment and decision-making skills, excellent communication abilities, emotional stability, and the capacity to work under pressure and meet deadlines. Attention to detail and multitasking in complex situations are essential.

Special Demands

Must have superior customer service skills, proficiency with computers and office technology, and the ability to work independently. Knowledge of medical, coding, and billing terminology, understanding of Revenue Cycle functions, and familiarity with EMR systems are required.