Hopedale Medical Complex · 6 hours ago
Prior Authorization Specialist, Hopedale IL Location, not a remote position
United States
Full-time
Remote
New Grad, Entry LevelHopedale Medical Complex is seeking a Prior Authorization Specialist to ensure payers are prepared to reimburse for scheduled services. The role involves contacting payers for service authorizations, determining insurance coverage, and providing financial counseling to patients.
Health CareMedicalNon Profit
Responsibilities
Verifies patient’s insurance and benefits information
Obtains prior authorizations from third-party payers in accordance with payer requirements
Works with other departments to gather the clinical information required by the payer to authorize services
Maintains accurate records of authorizations within the EMR
Works with the business office to support appeal efforts for authorization related denials
Complies with HIPAA regulations, as well as the organization's policies and procedures regarding patient privacy and confidentiality
Maintains professional tone at all times when communicating with patients and payer representatives
Completes approved adjustments as requested and adds charges as requested
Keep filing updated for easy access
Keep the waiting area orderly throughout the day
Assist in maintaining accurate patient business records
Orders and maintains supplies as required
Maintains good working relationship both within the department and with other departments
Demonstrates an ability to be flexible, organized and function well in a stressful situation
Treat patients and their families with respect and dignity; ensures confidentiality of patients personal and medical information
Follows established departmental policies, procedures, and objectives. Continues quality improvement objectives and safety, environmental and/or infection control standards
Other duties as assigned by the Patient Access Manager
Qualification
Required
Verifies patient's insurance and benefits information
Obtains prior authorizations from third-party payers in accordance with payer requirements
Works with other departments to gather the clinical information required by the payer to authorize services
Maintains accurate records of authorizations within the EMR
Works with the business office to support appeal efforts for authorization related denials
Complies with HIPAA regulations, as well as the organization's policies and procedures regarding patient privacy and confidentiality
Maintains professional tone at all times when communicating with patients and payer representatives
Completes approved adjustments as requested and adds charges as requested
Keep filing updated for easy access
Keep the waiting area orderly throughout the day
Assist in maintaining accurate patient business records
Orders and maintains supplies as required
Maintains good working relationship both within the department and with other departments
Demonstrates an ability to be flexible, organized and function well in a stressful situation
Treat patients and their families with respect and dignity; ensures confidentiality of patients personal and medical information
Follows established departmental policies, procedures, and objectives
Continues quality improvement objectives and safety, environmental and/or infection control standards
Other duties as assigned by the Patient Access Manager
Benefits
Tuition Reimbursement
Excellent benefits - health, dental, vision, and life and disability insurance
Quality childcare located on site
HMC Wellness Center membership
401(k) plan with employer match
Employee Daycare Rates
Infants (6 weeks to 15 months) - $133 weekly, $27 daily
Toddlers (15 months to 2 yrs) - $126 weekly, $26 daily
2 years to 3 years - $119 weekly, $25 daily
4 years to 5 years - $112 weekly, $23 daily
Company
Hopedale Medical Complex
Hopedale Medical Complex is a non-profit organization that offers independent living facilities and professional health & medical services.
Founded in 1955
201-500 employees
H1B Sponsorship
Hopedale Medical Complex has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2022 (3)
Funding
Current Stage
Growth StageCompany data provided by crunchbase