Prior Authorization Specialist: Fast, Accurate Approvals

Carle; Champaign (IL); Híbrido; USD 25 000 - 40 000; Tempo integral

Resumo da oferta

Carle Health in Champaign, IL is seeking a Pre-Authorization Specialist to identify prior auth requirements, submit authorizations for scheduled and add-on services, and verify coverage in Epic.

You will coordinate with ordering providers, document outcomes, and help reduce denials by timely communications and peer-to-peer reviews. The role requires a high school diploma or GED, basic English and computer skills, and a professional, helpful demeanor in a fast-paced healthcare environment.

Qualificações

• Education: Highschool Diploma or GED
• Required English Skills: Basic reading skills, Basic writing skills, Basic oral skills
• Communication Skills: Ability to respond appropriately to customer/co-worker and interact with a wide variety of people
• Computer Skills: Basic knowledge of word processing, spreadsheet, e-mail, and web browser; comfortable with Windows OS

Responsabilidades

• Analyzes information required to complete pre-authorizations based on multiple insurance/payer requirements.
• Proficiently utilizes third party payer/insurance portals to process pre-auth submissions.
• Documents pre-authorization results completely and communicates to leadership, Providers and/or Nurses approvals or denials.
• Advocates for patients/providers by processing pre-auths in a time sensitive manner and coordinating with physicians and nurses to obtain needed clinical information.

Conhecimentos

Communication skills

English skills

Basic computer skills

Formação académica

Highschool Diploma or GED

Ferramentas

Epic

Descrição da oferta de emprego

Carle Health in Champaign, IL is seeking a Pre-Authorization Specialist to identify prior auth requirements, submit authorizations for scheduled and add-on services, and verify coverage in Epic.

You will coordinate with ordering providers, document outcomes, and help reduce denials by timely communications and peer-to-peer reviews. The role requires a high school diploma or GED, basic English and computer skills, and a professional, helpful demeanor in a fast-paced healthcare environment.