Prior Authorization Specialist at Chadron Community Hospital, Corp. – Chadron, Nebraska

Serves as the primary front desk representative for the Radiology department while coordinating patient scheduling, registration, and prior authorizations. Ensures all imaging services are authorized, scheduled appropriately, and supported with complete and accurate documentation to promote efficient workflow and optimal patient care.

Full Time position Monday-Friday 8:00-4:30pm No Holidays/Weekends

PRIMARY RESPONSIBILITIES AND DUTIES:

• Greet and assist patients, visitors, and providers in a professional and courteous manner

• Obtains prior authorizations for radiology procedures in accordance with payer requirements

• Identifies authorization issues and refer patients to financial counseling when appropriate

• Schedule radiology procedures and maintain accurate and efficient department schedules

• Verify physician orders and ensure completeness prior to scheduling or services

• Communicate with providers, patients, other facilities, and insurance companies to gather required documentation for authorizations

• Track and follow up on pending authorizations to ensure timely approval of services

• Maintain accurate documentation of authorizations and patient records within the EHR system

• Coordinate with clinical staff, referring providers, and ancillary departments to ensure all prerequisites for imaging services are met

• Monitor and update schedules for changes, cancellations, or additional requirements

• Support denial and appeal processes related to authorization issues

• Prepare and distribute necessary documentation to medical records and other departments

• Assist with maintaining department supplies and organization of front desk operations

• May perform or assist with patient registration, including accurate entry and verification of demographic and insurance information

• May also assist or serve as back up for other departments in regards to prior authorization when needed

• Promote positive patient experience through effective communication and customer service

• Maintain confidentiality and comply with HIPAA and organizational policies

• Participate in process improvement initiatives to enhance workflow and patient care coordination

• Take part in quality/safety/ infection control improvement initiatives projects by observing/reporting/engaging/resolving any concerns or issues.

• Completes annual required Relias education

• All Duties assigned

• EDUCATION/LICENSURE/CERTIFICATION: High School Diploma or equivalent required. BLS required, can be completed after hire.

• EXPERIENCE: 1–2 years of healthcare, scheduling, front desk, or prior authorization experience preferred. Experience in radiology, hospital, or clinic setting preferred

• ESSENTIAL TECHNICAL MOTOR SKILLS: Ability to operate computer systems, talk in person on the telephone, hear in person and on the telephone, vision for close work, use of photocopier, fax machine, computer.

• INTERPERSONAL SKILLS: Ability to interact appropriately and professionally with patients, clinic staff, physicians, hospital staff, and the general public.

• ESSENTIAL PHYSICAL REQUIREMENTS: Be able to Lift 75 lbs. Requires setting, walking, standing, ability to be mobile, some bending, stooping, stretching and lifting, Requires eye and hand coordination and manual dexterity. Requires ability to move freely within the hospital setting to conduct job duties.

• ESSENTIAL MENTAL ABILITIES: Ability to process information and to effectively communicate with others.

• ESSENTIAL SENSORY ABILITIES: Must be able to visually receive and interpret nonverbal communications and to hear spoken communication with others.

• EXPOSURE TO HAZARDS: Limited exposure to chemicals.

• FOLLOW THE STANDARDS OF BEHAVIOR

• Integrity
• Compassion & Communication
• Accountability
• Respect
• Excellence
• Teamwork
• Safety