Strategic Prior Authorization & Referral Specialist

NEW MEDICAL HEALTH CARE; Wichita (KS); On-site; USD 38,000 - 48,000; Full time

Job summary

Hutchinson Clinic is seeking a Prior Authorization Specialist to obtain prior authorizations and predeterminations from payers for all services. The role involves collecting patient demographic, insurance, and clinical data to ensure reimbursement requirements are met, and entering information into Allscripts Practice Management for accurate claims submission.

You will serve as a primary resource on prior authorization requirements and educate providers and staff on the process, while adhering

Qualifications

• High School Diploma or GED required.
• Knowledge in medical service coding is preferred.
• Familiarity with medical terminology or willingness to learn.

Responsibilities

• Obtain prior authorizations from payers for inpatient and outpatient services.
• Collect demographic, insurance, and clinical information from patients.
• Enter prior authorization data into Allscripts Practice Management for claims filing.

Skills

Communication skills

EMR familiarity

Education

High School Diploma or GED

Job description

Hutchinson Clinic is seeking a Prior Authorization Specialist to obtain prior authorizations and predeterminations from payers for all services. The role involves collecting patient demographic, insurance, and clinical data to ensure reimbursement requirements are met, and entering information into Allscripts Practice Management for accurate claims submission.

You will serve as a primary resource on prior authorization requirements and educate providers and staff on the process, while adhering