Prior Authorization Specialist (Remote)

Franciscan Health • Full-time • Remote (United States) • $18.55 - $24.12 / hour • 2w ago

Work From Home

Work From Home Work From Home, Indiana 46544The Prior Authorization Specialist is responsible for obtaining prior authorization for provider practices which may include outpatient services, specialty care and other ancillary services. The Prior Authorization Specialist verifies insurance coverage and gathers clinical information to ensure that all reimbursement requirements are met. The ability to Compassionately engage in conversation with patients on their responsibilities for Copayment, Prepayment and Outstanding Balances.

WHO WE ARE

With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve.

WHAT YOU CAN EXPECT

Follows payer processes (website, fax, contact number) to submit appropriate clinical documentation; remains current on updates from payers to ensure appropriate reimbursement from payers.
Serves as primary resource to ambulatory clinics regarding the prior authorization process and requirements.
Collects clinical information regarding services to be rendered for prior authorizations.
Contacts payers to obtain prior authorizations; enters standardized documentation within electronic medical record, to identify prior authorization and the criteria surrounding each authorization.
Educates providers and their clinical staff regarding the prior authorization process; advises providers and their clinical staff when issues arise relating to obtaining prior authorization.
Primary resource to patients regarding prior authorization process.
Verifies that all insurance requirements have been met.

QUALIFICATIONS

Required High School Diploma/GED
1 year Prior Authorizations and Revenue Cycle Required

TRAVEL IS REQUIRED:

Never or RarelyJOB RANGE:Prior Authorization Specialist $18.55-$24.12

INCENTIVE:Not Applicable

EQUAL OPPORTUNITY EMPLOYER

It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law.

Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights.