Specialty Clinic Authorization Specialist

Eaton Rapids Medical Center; Eaton Rapids (MI); On-site; USD 36,000 - 42,000; Full time

Job summary

Theuniversityunion is seeking a full-time healthcare admin specialist in Eaton Rapids, MI to manage pre-certifications, verify insurance, and register patients in the EHR system. You will coordinate with departments to obtain authorizations for outpatient services and assist with billing inquiries.

Responsibilities include handling telephone inquiries, scheduling appointments, and maintaining patient records with confidentiality in line with HIPAA guidelines.

Qualifications

• High school diploma or equivalent required.
• Prior healthcare or office experience preferred.
• Confidentiality/HIPAA awareness required.
• Experience with scheduling/registration systems and EHR/EMR preferred.

Responsibilities

• Verify and obtain patient insurance and benefits details.
• Handle pre-certifications and pre-authorizations for outpatient services.
• Register patients in the hospital's EHR system and schedule appointments.
• Answer telephone lines and direct calls to appropriate staff.
• Assist with billing questions and patient inquiries.

Skills

Medical terminology

HIPAA compliance

Telephone etiquette

Insurance knowledge

Education

High School diploma or equivalent

Tools

EHR/EMR systems

Email

Data entry

Job description

• Location 1500 S MAIN,EATON RAPIDS, MI, 48827,United States
• Employee Type Full Time

Description

Performs timely pre-certifications, pre-authorizations, outpatient surgical procedures and appropriate outpatient studies, including but not limited to: CT’s, MRI’s, and in-office injection procedures. Interacts with the appropriate departments when necessary.

Obtains and maintains appropriate access to payor and third-party websites to obtain authorizations/pre-certifications electronically as well as verify insurance eligibility for patients.

Assists with answering telephones, registering patients, sorting and delivering mail, or any other department duty as needed. Performs any other duties as assigned by the Manager.

Greets all patients, families, and clinic visitors with a positive, cheerful attitude.

Requirements

BLS required within 90 days of hire and maintained throughout employment.High school diploma or equivalent required. Prior healthcare or office experience, medical terminology and insurance knowledge preferred. Experience with scheduling/registration systems, electronic health records (EHR/EMR), email, and basic data entry preferred. Confidentiality/HIPAA awareness, ability to protect patient health information required.

Summary

Verifies and obtains patient insurance and benefit details, pre-certification as appropriate for the following: outpatient/inpatient surgeries and procedures including CAT scans, MRIs, in-office injection procedures and any other outpatient services as required by healthcare and insurance guidelines. Handles patient billing or insurance questions. Registers all patients all patient types using the hospital's EHR system to obtain correct demographic, financial, social, clerical and clinical information. Does scanning into patient’s medical record. Answers telephone calls and appropriately takes messages within the medical record, schedules appointments, and/or directs call to appropriate individual.

Additional Information

• Hours Per Pay Period Full Time 72-80 Hours per bi-weekly pay