Prior Authorization Specialist - Onsite* at Cherry County Hospital Valentine, NE

Cherry County Hospital; Valentine (NE); On-site; USD 28,000 - 36,000; Full time

Benefits offered by this job

Health Insurance: Co-pay or HSA plan

Dental Insurance: 100% paid for?

Vision Insurance: 100% paid for

Group Life Insurance: $50,000 with AD&

Long-Term Disability: 100% paid for

Flexible Spending Accounts

Retirement Plan: 457 plan with Pre-Tax

Job summary

Cherry County Hospital in Valentine, NE, is hiring a Full-Time Onsite Prior Authorization Specialist to obtain pre-certifications for procedures and medications. You will verify eligibility with insurers, track pre-authorizations, and ensure timely approvals before services are rendered.

Strong communication, attention to detail, and knowledge of medical terminology and HIPAA are essential. Experience with Excel/Word is preferred; candidate should be able to work collaboratively in a team while

Qualifications

• High school diploma required.
• Prior customer service experience in a medical setting preferred.
• Knowledge of medical terminology preferred.
• Previous experience with Microsoft Excel, Word, and Windows.

Responsibilities

• Contact insurance carriers to verify patient eligibility, benefits, and requirements.
• Request, track, and obtain pre-authorizations for medical procedures and services.
• Follow up with insurance carriers to ensure timely authorizations before services are performed.
• Demonstrate knowledge of medical terminology, office procedures, and HIPAA regulations.
• Maintain a level of productivity appropriate for the department.
• Document all communications and contacts in a standardized format.

Skills

Excellent communication

Team collaboration

Organizational skills

Confidentiality

Attention to detail

Education

High school diploma

Tools

Microsoft Excel

Microsoft Word

Windows

Job description

Description:

Location:

Cherry County Hospital, Valentine, NE

Position:

Full-Time (40 hours/week) – Onsite

Compensation:

Competitive wage based on experience

Benefits:

Eligible for benefits

Now Hiring – Prior Authorization Specialist:

About the Position

Cherry County Hospital is seeking a dedicated and detail-oriented Prior Authorization Specialist to join our team. In this important role, you will be responsible for obtaining pre-certifications and pre-authorizations for medical procedures and medications at our hospital and clinic.

Duties and Responsibilities

• Contact insurance carriers to verify patient eligibility, benefits, and requirements.


• Request, track, and obtain pre-authorizations for medical procedures and services.


• Follow up with insurance carriers to ensure timely authorizations before services are performed.


• Demonstrate knowledge of medical terminology, office procedures, and HIPAA regulations.


• Communicate insurance changes or trends to appropriate departments.


• Maintain a level of productivity appropriate for the department.


• Appeal insurance/payor denials when applicable.


• Document all communications and contacts in a standardized format.


• Notify department heads of additional staffing or equipment needs.


• Assist with filing and record retrieval as needed.


• Work cooperatively and effectively with staff, physicians, and the public.


• Maintain strict confidentiality of patient medical, personal, and financial information.


• Follow corporate compliance policies and procedures.


• Perform additional duties as assigned by the supervisor.

Skills and Abilities

• Excellent verbal and written communication skills.


• Proficiency with computers and Microsoft Excel, Word, and Windows.


• Strong organizational skills and ability to interpret data.


• Strong judgment, tact, diplomacy, and problem-solving skills.


• Ability to work collaboratively in a team environment.


• Strong attention to confidentiality of hospital and patient information.


• Ability to perform repetitive tasks with minimal independent judgment.


• Familiarity with state and federal confidentiality laws, including HIPAA, and the ability to follow policies regarding the privacy and security of health information.

Physical Demands and Working Conditions

• Sedentary work involving periods of sitting, talking, typing, and listening.


• Repetitive use of hands, arms, and eyes, which may cause strain.


• Significant manual dexterity required to operate business office machines and equipment.

Job Requirements

• High school diploma required.


• Prior customer service experience in a medical setting preferred.


• Knowledge of medical terminology preferred.


• Previous experience with Microsoft Excel, Word, and Windows.

Comprehensive Benefit Package

• Health Insurance: Co-pay or HSA plan options; 100% paid for employee.


• Dental Insurance: 100% paid for employee.


• Vision Insurance: 100% paid for employee.


• Group Life Insurance: $50,000 with AD&D.


• Long-Term Disability: 100% paid for employee.


• Flexible Spending Accounts: Medical and dependent care options.


• Health Savings Account: Includes employer contribution.


• Supplemental Insurance: Short-Term Disability, Supplemental Life and AD&D, Critical Illness, Hospital Indemnity, and Accident.


• Retirement Plan: 457 plan with Pre-Tax and Roth options.

Why Cherry County Hospital?

• Be part of a dedicated and compassionate healthcare team.


• Enjoy competitive pay and excellent benefits.


• Work in a collaborative and supportive environment.


• Make a meaningful contribution to healthcare in our community.

Requirements:

• High school diploma required


• Prior customer service experience in a medical setting preferred


• Knowledge of medical terminology preferred


• Previous experience with Microsoft Excel, Word, and Windows


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