Prior Authorization Specialist in Osage Beach, MO, Missouri at Lake Regional Health System

Principal Accountabilities and Essential Duties for Prior Authorization Specialist position

Promotes customer service and satisfaction through competent professional practice and focus on patient needs and expectations.

• Effectively facilitates the coordination of the continuum of patient care in a timely, caring manner, including but not limited to, prior authorizations, verification of patient’s insurance coverage, and coordination of appointments.
• Promotes a positive image through an efficient and cooperative approach to all tasks.
• Presents a professional approach and appearance, a friendly smile and pleasant tone of voice.
• Maintains a calm, caring, and re-assuring demeanor
• Operates as an active part of the team and uses constructive problem-solving
• Maintains confidentiality and refrains from criticism of co-workers, clinics, hospital, guests, and patients.
• Assists the providers and nurses with patient referrals

Functions as a focal communication source.

• Greets patients in a friendly, courteous and professional manner
• Communicates patient care information to appropriate parties in a timely manner
• Maintains necessary forms
• Coordinates and arranges patient referrals and documents all information.
• Acts as a liaison with all insurance personnel in obtaining referral authorizations.
• Acts as a communication link between the physician, nurse, and office manager.

Maintains medical record information and associated confidentiality.

• Serves as a resource to new and existing staff
• Remains flexible and adaptable to changing priorities and performs other duties as assigned
• Coordinates and documents the release of a patient’s medical records to other entities.
• Know how to use MS Word and ability to compose letters

Participates as a member of multidisciplinary teams to coordinate care and ensure continuous improvement in quality of services.

• Attends staff meetings and participates in inter and intra-clinic work teams
• Attends all required in-service and continuing education
• Cross trained to work in a role as a receptionist.

Must have a high school diploma or equivalent.

Preferred knowledge of how health insurance works and terminology.

An annual influenza vaccination is required.

Lake Regional Health System has a competitive benefit and compensation package.