Emerson Hospital Prior Authorization Specialist - Full Time in Concord, Massachusetts
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.
High School Diploma or equivalent required.
Associates Degree preferred.
Work experience may be substituted for higher education.
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
Knowledge of third party payors.
Knowledge of Medicare billing practices and regulations.
Insurance verifications experience.
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.