Prior Authorization Specialist | Full Time | Days | SRH Authorization Access Services

Singing River Healthcare Academy; Pascagoula (MS); Hybrid; USD 42,000 - 56,000; Full time

Job summary

Singing River Health System is seeking an Authorization Specialist to evaluate medical services for authorization requirements and obtain payer approvals for imaging, oncology, rheumatology, and other services. You will work within established policies and state and federal guidelines.

Responsibilities include coordinating with payers and using the EMR efficiently while maintaining excellence in customer service and accuracy in documentation.

Qualifications

• High School diploma or equivalent required.
• Associates or bachelor’s in business finance, healthcare administration, or related field preferred.
• Certification as a Prior Authorization Certified Specialist preferred; de-escalation training completed within 90 days.

Responsibilities

• Evaluate medical services ordered for authorization requirements and obtain authorization for diagnostic imaging, radiation therapy, oncology, rheumatology and other services for reimbursement.
• Coordinate with payers to obtain authorizations as needed.
• Follow Singing River Health System procedures, accrediting organizations, and governing guidelines.

Skills

De-escalation training

Customer service

MS Outlook

MS Word

MS Excel

MS PowerPoint

Education

High School diploma

Associates or Bachelor’s in business finance or healthcare administration

Tools

EMR system

Job description

At Singing River Health System, caring isn't just part of the job- it's in our DNA. Whether we're saving lives, supporting behind the scenes, or showing up for our community, we bring the energy, heart, and hustle every single day. With pride, passion, and commitment, we will improve health and save lives in our community every day.

Shift: Monday - Friday (8:00 AM - 4:30 PM) Location: Pascagoula Financial Services Building

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 when necessary for reimbursement. Expectation is for all performed duties to be in accordance with Singing River Health System procedures and policies, accreditation organization, and governing guidance and publications for health care employees.

DISCLAIMER: This is not necessarily an exhaustive list of all responsibilities, duties, skills, efforts, requirements or working conditions associated with the job. While this intends to be an accurate reflection of the current job, management reserves the right to revise the job or to require that other or different tasks performed as assigned.

Education

• High School diploma or equivalent required.
• Associates 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. Must have de-escalation training completed by the end of position orientation (90 days); must have appropriate level of de-escalation training.

Experience

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

Reports to

Patient Access Services Manager

Supervises

N/A

Physical Demands

Work involves moderate physical activity: frequently moving about the office, building, or other facilities within the SRHS service area; frequently positioning self to access files, computers, equipment, and other objects; performing repetitive motions with wrists, hands and fingers in using the keyboard and other office equipment. Work involves being able to perceive the nature of sounds at normal speaking levels, with or without correction. Must demonstrate the ability to communicate, speak, and enunciate to express / exchange ideas and detailed information in person and on the telephone. Work requires a minimum standard of visual acuity, with or without correction, with the ability to adjust the eye to bring an object into sharp focus, i.e. shift gaze from viewing a computer monitor to forms that are closer to compare data at close vision.

Mental Demands

Must demonstrate keen mental faculties/assessment and decision making abilities. Must demonstrate superior communication/speaking/enunciation skills to receive and give information in person and by telephone. Must demonstrate strong written and verbal communication skills. Must possess emotional stability conducive to dealing with high stress levels. Must demonstrate ability to work under pressure and meet deadlines. Attention to detail and the ability to multi-task in complex situations is required. Must have the ability to maintain collaborative and respectable working relationships throughout SRHS and other organizations.

Special Demands

Must possess superior customer service skills and professional etiquette. Must possess proficient knowledge and ability to use a computer (must be keyboard proficient) and other office technology (i.e., telephone, fax, etc.). Must have working knowledge of MS Outlook, Word, Excel, and PowerPoint. Work requires the ability to function independently, adapt to workload demands, set priorities, and understand and set goals. Must understand the fundamentals of automated data processing, and be able to quickly gain a detailed understanding of complex computerized and non-computerized information. Must possess knowledge of medical, coding, and billing terminology. Must have an understanding of Revenue Cycle functions in a hospital setting and thorough knowledge of state and federal laws, as they apply. Must be able to navigate within an Electronic Medical Record (EMR).

If you're looking for purpose, teamwork, and a place where what you do truly matters, you've found it. Let's do big things together.

Singing River is both a mission-driven healthcare provider and one of the largest employers on the Mississippi Gulf Coast. We offer best-of-industry benefits, scheduling options, and professional pathways for our employees. Within each of our three hospitals and 50+ primary care and specialty clinics, you'll find a team devoted to quality, teamwork, and service.