Authorization Specialist (Days)

We are seeking an Authorization Specialist in the Admitting department at Riverview Regional Medical Center (Gadsden, AL), a member of Prime Healthcare. As an Authorization Specialist you will reviews databases and other pertinent documentation to ensure all needed pre-certifications and/or authorizations are completed for medical services.

Shift's Available: Days

Employment Type: Full Time

Hours: 7:45AM - 4:15PM Monday - Friday

Here are some of the benefits of working at Prime Healthcare:

Health, dental, and vision insurance options
• Paid vacation, sick time and holidays
• Bereavement leave, FMLA and other leave options
• Employer 401K options
• Tuition reimbursement options
• Life, disability, and other insurance options
• Many other amazing benefits

Essential Duties and Responsibilities (includes, but not limited to):

• Secures insurance information, eligibility, benefits and authorizations as applicable.
• Review patient information, contact payers, and ensure timely and accurate completion of authorization requests.
• Requires strong customer service skills in order to answer inquiries from patients and healthcare providers.
• Ability to collect copays/pre-pays.
• Works closely with all facets of the Admitting department including PBX operator function and reception areas.
• Must be able to operate a computer to input and retrieve data.
• Ability to communicate with the population served, utilizing age specific techniques from neonatal, pediatrics, adolescents, young adults, middle adult to geriatrics.
• Maintain proficiency in medical terminology.
• Special projects or other assignments may be given with expectations to be completed in a specified timeframe

EDUCATION, EXPERIENCE, TRAINING

• Knowledge of standard insurance companies and verification requirements.
• Well versed in authorization processes for all payers
• Knowledge of medical terminology
• Basic computer skills
• Knowledge of Common Procedural Terminology (CPT), ICD codes
• Ability to multi-task, prioritize needs to meet required timelines
• Analytical and problem-solving skills
• Customer Services experience required
• High School Graduate or GED Equivalent required (effective 4/1/14 for all new hires)
• 3-5 years pre-certification processes and medical necessity guidelines preferred

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf