Prior Authorization Specialist — Patient Finance

Box Butte General Hospital; Alliance (NE); On-site; USD 32,000 - 42,000; Full time

Job summary

Box Butte General Hospital is seeking a PFS Prior Authorization Specialist to verify insurance coverage, pre-certification, and pre-authorization requirements for inpatient, observation, and outpatient services. The role involves coordinating with Utilization Review and Surgery departments to ensure timely pre-certification and maintaining positive patient relations.

Essential duties include contacting insurance companies, gathering demographic data, and documenting eligibility and authorization

Qualifications

• Proficient computer skills and keyboarding speed.
• Experience using telephone for customer information gathering preferred.
• Attention to detail and ability to navigate multiple systems.

Responsibilities

• Verify insurance coverage, pre-certification and/or pre-authorization requirements for inpatient, 23-hour observation and outpatient services.
• Coordinate with Utilization Review, Surgery and other departments to meet pre-certification requirements.
• Contact insurance companies to verify coverage and benefits for patients.

Skills

Computer Skills

Keyboarding

Telephone experience

Education

High school diploma

Job description

Box Butte General Hospital is seeking a PFS Prior Authorization Specialist to verify insurance coverage, pre-certification, and pre-authorization requirements for inpatient, observation, and outpatient services. The role involves coordinating with Utilization Review and Surgery departments to ensure timely pre-certification and maintaining positive patient relations.

Essential duties include contacting insurance companies, gathering demographic data, and documenting eligibility and authorization