Insurance & Prior Authorization Specialist

Job Description

As an Insurance Prior Authorization Specialist, you will be focused on helping patients access the care they need by navigating insurance requirements, obtaining authorizations, verifying medical necessity, coordinating clinical reviews and appeals. You will partner closely with providers, payers, and clinical and financial teams to resolve barriers, manage changing priorities, and keep services moving forward, while also using their expertise to identify process improvements, support and educate team members, and ensure work is completed accurately, efficiently, and with the patient experience in mind

Qualifications

• Associate’s degree in Health Services Administration or Business related field preferred. In lieu of degree, 3 years internal revenue cycle experience will be considered, or one year internal insurance verifier. Minimum productivity requirements, and peer review process are required.
• Successful completion of Medical Terminology course, and Anatomy course is required.
• Knowledge of current third-party payer reimbursement rules required.

Additional Information

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Munson Healthcare requires all employees be vaccinated or have lab confirmed immunity for Measles, Mumps, Rubella and Varicella. MHC also requires all employees to receive a flu vaccine during the flu season in the year that they are hired and annually thereafter, or receive an approved medical or religious exemption.