Prior Authorization Specialist
Company: Singing River Health System
Location: Pascagoula
Posted on: April 24, 2024
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Job Description:
Prior Authorization Specialist
Financial Services Building - Pascagoula / Full-Time / Monday -
Friday, 8:00am-4:30pm /
Pascagoula, Mississippi, 39581
United States
PositionOverview:The Authorization Specialist evaluates medical
services ordered for authorization requirements with payers and
obtains authorization for diagnostic imaging, radiation therapy,
oncology, rheumatology, and other services when necessary for
reimbursement.
Expectation is for all performed duties to be in accordance with
Singing River Health System procedures and policies, accreditation
organization, and governing guidance and publications for health
care employees.
DISCLAIMER: This is not necessarily an exhaustive list of all
responsibilities, duties, skills, efforts, requirements or working
conditions associated with the job. While this intends to be an
accurate reflection of the current job, management reserves the
right to revise the job or to require that other or different tasks
performed as assigned.
Education:High School diploma or equivalentrequired. Associates or
bachelor's degree in business finance, healthcareadministration, or
related field preferred.
License:N/A
Certifications:Must obtain certification as a Prior Authorization
Certified Specialist through the National Board of Prior
Authorization Specialists within 6 months of job start. Must
maintain active certification while in this role.
Experience:Experience in a hospital or physician office setting
obtaining authorizations for diagnostic imaging services or medical
oncology services preferred.
Reports to:Patient Access Services Manager
Supervises:N/A
Physical Demands:Work is moderately active: involves sitting with
frequent requirements to move about the office, move about the
facility, and to travel to another facility within the SRHS service
area. Work involves exerting a negligible amount of force
frequently to lift, carry, push, pull, or otherwise move objects,
including the human body.
Work involves using many physical motions in performing daily work
activities; subject to exposure of body fluids, sputum and tissues,
which may carry the hazard of infectious disease. Work involves
using repetitive motions: substantial movements of the wrists,
hands, and or fingers while operating standard office equipment
such as computer keyboard.
Work involves being able to perceive the nature of sound at normal
speaking levels with or without correction; the ability to make
fine discriminations in sound. Work requires close visual and
acuity and the ability to adjust the eye to bring an object into
sharp focus, i.e. shift gaze from viewing a computer monitor to
forms/printed material that are closer to compare data at close
vision.
Must be able to be active for extended periods of time without
experiencing undue fatigue. Must be able to work schedules assigned
with the understanding that changes may be instituted according to
the needs of the hospital for off days, shifts or weekends.
Mental Demands:Must demonstrate keen mental faculties/assessment
and decision making abilities. Must demonstrate superior
communication/speaking/enunciation skills to receive and give
information in person and by telephone. Must demonstrate strong
written and verbal communication skills. Must possess emotional
stability conducive to dealing with high stress levels. Must
demonstrate ability to work under pressure and meet deadlines.
Attention to detail and the ability to multi-task in complex
situations is required. Must have the ability to maintain
collaborative and respectable working relationships throughout SRHS
and other organizations.
Special Demands:Must possess superior customer service skills and
professional etiquette. Must possess proficient knowledge and
ability to use a computer (must be keyboard proficient) and other
office technology (i.e., telephone, fax, etc.), MS Outlook and
Word.
Work requires the ability to function independently, adapt to
workload demands, set priorities, and understand and set goals.
Must understand the fundamentals of automated data processing, and
be able to quickly gain a detailed understanding of complex
computerized and non-computerized information.
Must possess knowledge of medical, coding, and billing terminology.
Must have an understanding of Revenue Cycle functions in a hospital
setting and thorough knowledge of state and federal laws, as they
apply. Must be able to navigate within an Electronic Medical Record
(EMR).
Keywords: Singing River Health System, Biloxi , Prior Authorization Specialist, Other , Pascagoula, Mississippi
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