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Emerson Hospital Prior Authorization Specialist - Full Time in Concord, Massachusetts

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.