Prior Authorization Specialist I

Caring For the Community You Love Choose a career to make a difference in people's lives every day, choose Fisher-Titus! Perks of working at Fisher-Titus: • Hours of Work- Full time • Comprehensive Benefits Package- Medical & Dental coverage, 401K match, paid time off, tuition assistance and more! • Shift, Weekend & PRN differential About Fisher-Titus: Fisher-Titus proudly serves the greater Huron County area’s 70,000-plus residents by providing a full continuum of health and wellness care from heart and cancer care to outpatient services such as lab, imaging, and physical rehabilitation. Vision: Be the first choice for healthcare and employment within our community Mission: Deliver compassionate and convenient care to the highest level of excellence that promotes lifelong health and wellness for our community General Summary: The Prior Authorization Specialist I is responsible for ensuring that payers are prepared to reimburse Fisher-Titus for services in accordance with the payer-provided contract. The Specialist contacts payers to request service authorization and may collect financial and/or demographic information from patients as needed. Essential Functions: • Verifies patients’ insurance and benefits information • Obtains prior authorization from third-party payers in accordance with payer requirements • Will contacts patients to gather demographic and insurance information as needed, and updates patient information within the EMR as necessary • Works with other departments to gather the clinical information required by the payer to authorize services • Maintains accurate records of authorizations within the EMR • Identifies patients who will need to receive Medicare Advance Beneficiary Notices of Noncoverage (ABNs) • Refers accounts to financial counseling as needed if authorization is not obtained • Works directly with and supports the needs of the Denial/Appeals committee. • Complies with HIPAA regulations, as well as the organization's policies and procedures regarding patient privacy and confidentiality • Continually maintains professional tone when communicating with patients and payer representatives • Performs other clerical duties as requested Education Required • Associates or better in Business Administration Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor. Apply tot his job Apply To this Job