Prior Authorizations Specialist
Job Location
Department
20 November, 2023
Full Time
Day
363113
Prior Authorizations Specialist
Job Description
Overview
Collaborates with physicians, patients, and insurance companies to pre-certify medical services and procedures in order to deliver quality medical care in the most cost effective manner. Serves as pivotal point for communication among these parties. Provides assistance in utilization management and related duties by working collaboratively with the multidisciplinary team to achieve desired clinical, service and cost outcomes. Ensures that patients presenting for treatment obtains authorization from third party payers in order to expedite the receipt of full and timely reimbursement. Provides valuable information for consideration in clinical decision-making. Promotes quality patient care and to prevent costly payment denials and reduce the institution's financial risk.
This position will work with the care team and insurance companies to get authorization for genetic services and testing. Remote work or hybrid schedules, within Indiana, are a possibility after onboarding and training.
• Minimum one-year medical office experience or combination of extensive customer service work experience and education in insurance verification, patient registration, and medical terminology.
• Requires working knowledge of payer billing requirements, regulations, and the third party appeal and denial process.
We are an equal opportunity employer and value diversity and inclusion at IU Health. IU Health does not discriminate on the basis of race, color, religion, sex, sexual orientation, age, disability, genetic information, veteran status, national origin, gender identity and/or expression, marital status or any other characteristic protected by federal, state or local law. We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation.
Qualifications for the Prior Authorizations Specialist Role
Overview
Collaborates with physicians, patients, and insurance companies to pre-certify medical services and procedures in order to deliver quality medical care in the most cost effective manner. Serves as pivotal point for communication among these parties. Provides assistance in utilization management and related duties by working collaboratively with the multidisciplinary team to achieve desired clinical, service and cost outcomes. Ensures that patients presenting for treatment obtains authorization from third party payers in order to expedite the receipt of full and timely reimbursement. Provides valuable information for consideration in clinical decision-making. Promotes quality patient care and to prevent costly payment denials and reduce the institution's financial risk.
This position will work with the care team and insurance companies to get authorization for genetic services and testing. Remote work or hybrid schedules, within Indiana, are a possibility after onboarding and training.
- Requires High School diploma or equivalent.
- Minimum one-year medical office experience or combination of extensive customer service work experience and education in insurance verification, patient registration, and medical terminology.
- Requires working knowledge of payer billing requirements, regulations, and the third party appeal and denial process.
Indiana University Health is Indiana’s most comprehensive health system, with 16 hospitals and nearly 40,000 team members serving Hoosiers across the state. Our partnership with the Indiana University School of Medicine gives our team members access to the very latest science and the very best training, advancing care for all. We’re looking for team members who share the things that matter most to us. People who are inspired by challenging and meaningful work for the good of every patient. People who are compassionate and serve with a purpose. People who aspire to excellence every day. People who are always ready to apply themselves.
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