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    Prior Authorization Specialist - Concord, United States - Emerson Hospital

    Emerson Hospital
    Emerson Hospital Concord, United States

    1 week ago

    Default job background
    Full time
    Description

    Prior Authorization Specialist - hybrid after onsite training - Full Time 8am-4:30pm


    Job Ref: 29384

    Category: Clerical & Administrative Support

    Location:

    Emerson Hospital,
    133 Old Road to Nine Acre Corner,

    Concord,
    MA 01742

    Department: Patient Access

    Schedule: Full Time

    Shift: Day shift

    Hours: 8:00-4:30

    Job Summary Reports to the Direct of Patient Access, the position serves as the hospital`s primary contact for patient reimbursement issues in accordance with established credit policies. The position works with third-party payors for necessary authorizations and verification of coverage issues. The position also provides cashiering services for Emerson Hospital. Minimum Qualifications
    • Education
      • High School Diploma or equivalent required.
      • Associates Degree preferred.
      • Work experience may be substituted for higher education.
    • Experience
      • One to 3 years as a financial counselor at a hospital and/or authorization coordinator required
        and/or
        3-5 years full-time admitting experience with insurance knowledge required
      • Knowledge of insurances, pre certification and referral procedures required
      • Knowledge of the Virtual Gateway and Medicaid applications preferred
      • Experience in working with patients required
      • Experience in working with payers to appeal pre auth denials preferred
    • Licensure and/or Certification
      • None required
    • Skills
      • Knowledge of third party payors.
      • Knowledge of Medicare billing practices and regulations.
      • Insurance verifications experience.
      • Computer proficiency.
      • Excellent interpersonal skills are required to interact effectively with all organizational levels, with demonstrated organizational skills and ability to work accurately with detailed confidential information.
      • Must have the ability to read, write and communicate in English.
      • Must be highly organized, cooperative, and able to work well with others.
      • Ability to prioritize and perform multiple tasks.
      • Thorough understanding of team management concepts.
      • Comprehensive knowledge of medical terminology.
      • The ability to effectively communicate with external organizations as well as various levels of management required.


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