Prior Authorization Specialist in Northfield, Minnesota at Northfield Hospital & Clinics

Job Summary

As the Prior Authorization Specialist, you will monitor incoming orders and gather necessary documentation to ensure pre-certification, authorization, and referral requirements are met prior to the delivery of inpatient, outpatient, and ancillary services.

Compensation

We are committed to providing wage ranges for all open positions. Please note that the specific compensation for this role will be determined based on experience, education and internal equity considerations. The hourly wage range for this position is $18.74–$26.45. This range reflects the base salary for this position.

Key Responsibilities:

• Works with insurance companies and staff to obtain initial and ongoing authorizations for patients in advance of services.
  • Reviews accuracy and completeness of information requested to ensure that all supporting documents are present.
  • Provides feedback to referring provider office so patient services can be scheduled.
  • Provides authorization number to internal teams (providers, billers, etc.).
• Researches, corrects, and resubmits rejected/denied insurance authorizations.
• Communicates with patients, clinic personnel, and providers over the phone, via email or other written documentation and responds to all inquires.
• Utilizes and maintains online prior authorization software.

Qualifications

• High School diploma or equivalent
• Must be able to speak, read, and write English proficiently to ensure safe and effective communication in a healthcare environment
• Previous customer service experience
• General computer skills and experience
• Ability to work in a high volume/fast-paced environment
• Prior authorization knowledge/experience, Preferred

Schedule:

• 80hrs/2wks
• Monday-Friday:8:30am - 5:00pm