Prior Authorization Specialist at Cherry County Hospital

Valentine, Nebraska, United States -

Full Time

Start Date

Immediate

Expiry Date

27 May, 26

Salary

21.08

Posted On

26 Feb, 26

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Verbal Communication, Written Communication, Computer Proficiency, Microsoft Excel, Word, Windows, Organizational Skills, Data Interpretation, Judgment, Tact, Diplomacy, Problem-Solving, Teamwork, Confidentiality Maintenance, HIPAA Compliance, Medical Terminology

Industry

Hospitals and Health Care

Description

Description Location: Cherry County Hospital, Valentine, NE Position: Full-Time (40 hours/week) - Onsite Compensation: Starting at $21.08/hr (Based on Experience) Benefits: Eligible for benefits Cherry County Hospital is seeking a dedicated and skilled Prior Authorization Specialist to join our team. In this vital role, you will be responsible for obtaining pre-certifications and pre-authorizations for medical procedures and medications at our hospital and clinic. Duties and Responsibilities: As a Prior Authorization Specialist, you will: Contact insurance carriers to verify patient insurance eligibility, benefits, and requirements Request, track, and obtain pre-authorizations for medical procedures and services Follow up with insurance carriers to ensure timely authorizations before services are performed Demonstrate a solid understanding of medical terminology and office procedures, including HIPAA regulations Communicate any insurance changes or trends to relevant departments Maintain a level of productivity suitable for the department Appeal insurance/payor denials when applicable Document all communications and contacts in a standardized format Notify department heads of any additional staffing or equipment needs Assist with occasional filing or record retrieval as needed Cooperate and work effectively with staff, public, and physicians Ensure the confidentiality of all patient medical, personal, and financial records Practice and adhere to corporate compliance policies and procedures Perform additional duties as assigned by the supervisor Skills and Abilities: Excellent verbal and written communication skills Proficiency with computers and related software (Microsoft Excel, Word, and Windows) Strong organizational skills and the ability to interpret data Strong judgment, tact, diplomacy, and problem-solving skills Ability to work collaboratively in a team environment Strong attention to maintaining confidentiality of hospital and patient information Ability to perform repetitive tasks with minimal independent judgment Familiarity with state and federal confidentiality laws, including HIPAA, and the ability to follow policies regarding the privacy and security of health information Physical Demands and Working Conditions: Sedentary work involving periods of sitting, talking, typing, and listening Repetitive use of hands, arms, and eyes, which may cause strain Significant manual dexterity to operate business office machines and equipment Why Cherry County Hospital? Be part of a dedicated, compassionate healthcare team Competitive pay and excellent benefits Work in a collaborative and supportive environment Apply Now! Join our team at Cherry County Hospital and contribute to the delivery of exceptional healthcare services in our community. Requirements High school diploma required Prior customer service experience in a medical setting preferred Knowledge of medical terminology preferred Previous experience with Microsoft Excel, Word, and Windows

Responsibilities

The specialist is responsible for obtaining pre-certifications and pre-authorizations for medical procedures and medications by contacting insurance carriers to verify eligibility and requirements. This role also involves tracking authorizations, following up with carriers, and appealing insurance denials when necessary.