System Authorization Specialist

St. Francis Medical Center; United States; Remoto; USD 42.000 - 60.000; Tempo pieno

Vantaggi offerti da questo lavoro

Health coverage

Education assistance

Retirement benefits

ETO based on years of service

Descrizione del lavoro

Saint Francis Healthcare System is seeking an Authorization Specialist to review prior authorization requests for medical services, including surgeries and home health, in line with coverage guidelines. The role emphasizes independent problem solving, accurate documentation, and collaboration to keep authorizations moving smoothly.

You will support efficient workflows, maintain confidential information, and provide quality customer service across departments as part of Saint Francis Healthcare

Competenze

• One year of experience in a healthcare setting obtaining insurance authorizations strongly preferred.
• Experience with CPT and ICD codes is a plus.

Mansioni

• Review requests for prior authorization of medical services including elective and outpatient surgeries and procedures
• Determine benefit eligibility and document in accordance with guidelines
• Serve as liaison to create smooth workflows and transitions of information needed for authorizations
• Deliver quality customer service

Formazione

High school graduate or equivalent

Strumenti

CPT and ICD codes

Descrizione del lavoro

JOB SUMMARY

The Authorization Specialist position is responsible for reviewing requests for prior authorization of medical services including elective and outpatient surgeries and procedures, home health, out of network requests, and expedited requests for medical necessity in accordance with government, commercial, and workers compensation health plan coverage guidelines. This individual is responsible for benefit determination and documenting completely and accurately in accordance with healthcare system guidelines. This position works well independently solving problems and acts as liaison with others outside the department to create smooth workflows and transitions of information needed for authorizations. Promotes harmonious and efficient intra and inter departmental relationships and delivers quality customer service. Adheres to the Mission, Vision, Values and Philosophy of the departments and Saint Francis Healthcare System. Constantly works with and maintains restricted or confidential information from many sources within the healthcare system. Any and all duties as assigned by Manager and Director.

JOB DETAILS AND REQUIREMENTS

Standard Shift: Monday-Friday 8:00am-4:30pm

Education:

High school graduate or equivalent required.

Experience:

• One year of experience in a healthcare setting obtaining insurance authorizations strongly preferred.




• Experience with CPT and ICD codes is a plus.

ADDITIONAL INFORMATION

Why Work at Saint Francis?

Saint Francis Healthcare System began in 1875 when three courageous Franciscan Sisters answered a call to care for those in need. What started as a 12-bed hospital has grown into the region’s leading healthcare system—recognized nationally for exceptional quality, safety, and patient experience.

Today, Saint Francis serves more than 715,000 people across five states. With a 306-bed Medical Center , nearly 3,000 team members , and over 300 providers , Saint Francis is not only the largest healthcare system between St. Louis and Memphis—it’s a powerful economic anchor for the communities it serves.

You’ll find more than 50 specialties , the region’s only Level III Emergency and Trauma Center , and southeast Missouri’s first Level III NICU. The system’s employed physician group, Saint Francis Medical Partners, supports more than 40 outreach clinics and 70% of the area’s primary care providers.

A Mission That Matters

At Saint Francis, you’re not just doing a job - you’re part of a Catholic healing ministry rooted in compassion, dignity, and service. Every action is inspired by a commitment to honor human life and care for every person who walks through the doors.

Mission

To provide a ministry of healing, wellness, quality, and love inspired by our faith in Jesus Christ.

Vision

To be a leading Catholic healthcare system that celebrates and protects the gift of life by providing exceptional patient outcomes in quality, safety, access and value.

Values You Can Feel Every Day

• Integrity: Doing what’s right, even when no one is watching




• Stewardship: Managing resources wisely for the future




• Faith: Believing in a purpose greater than ourselves




• Hope: Lifting up those who feel discouraged




• Joy: Serving others with a grateful, happy heart




• Compassion: Seeing others through Christ’s eyes




• Excellence: Always striving to be the best




• Dignity: Respecting human life from beginning to end

If You’re Looking to Make a True Impact…

Saint Francis offers a workplace where your work has purpose, your team feels like family, and your contributions support a mission that has been changing lives for more than 150 years.

Total Rewards

Our most important asset is our colleagues. That’s why Saint Francis Healthcare System offers a comprehensive benefits program to meet all your needs. Colleagues working at least 24 hours per week will have access to our Total Rewards package as outlined below.

• Comprehensive and affordable health coverage including medical, prescription, dental and vision - available on the first of the month after hire date




• Saint Francis Medical Services Discount




• Earned Time Off (ETO) based on relevant years of work history. ETO combines vacation, sick, holidays, and personal days into one balance to allow for flexibility




• Retirement benefits including SFHS immediate matching




• Education Assistance benefits up to $5,000 per calendar year for one year of service after graduation




• Other benefits including: Benefit Support through Health Advocate, Employee Assistance Program, Flexible Spending Accounts, Identity Theft Protection, Pet Insurance, Earned Wage Access

To learn more about our Total Rewards package and eligibility, visit www.sfmc.net/careers/benefits/.

Saint Francis Healthcare System provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, sexual orientation, gender identity, or genetics. In addition to federal law requirements, Saint Francis Healthcare System complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

In compliance with the ADA Amendments Act (ADAAA) should you have a disability and would like to request an accommodation in order to apply for a currently open position with Saint Francis Healthcare System, please call 573-331-5152 or email us at [e-mail].