Job description
Job Category
Business Office
Position
Insurance Authorization Specialist
Req Code
23698
Location
Skagit Valley Hospital
Job Summary
The information described in this job description has been designed to indicate the general nature of the work performed. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this job. Responsible for ensuring the pre-service administrative requirements are met for all scheduled appointments. Works effectively and cooperatively within the workplace. Location/Department specific tasks and competencies may apply.
Essential Functions
Document eligibility, benefit and authorization information in accordance with established guidelines. Initiate all insurance requirements for specific admission type in accordance with established guidelines. Verify prior authorizations and/or pre-service requirements are met prior to date of service for each service type. Refer self pay patients to Patient Financial Services in accordance with established guidelines. Review and resolve denial issues in a timely manner in accordance with established guidelines. Verify current eligibility, benefits and plan coverage in accordance with established guidelines. Track and submit retro-authorization requests, working closely with referring physician offices to resolve issues. Utilize available tools and on-line resources to create efficiencies in the process. Maintain ability to effectively utilize Microsoft Office (Outlook) and department specific software applications to perform work. Communicate effectively and cooperatively in the workplace. Actively contribute to the achievement of Quality Improvement and Lean Process Improvement activities. Complete all mandatory learning requirements in a timely manner. Attend and actively participate in all department, team and/or committee meetings. Comply with all Skagit Regional Health, department and location specific policies and procedures. Perform other duties as assigned by Supervisor or designee.
Education
High School graduate or GED required.
Experience/Training
Minimum three (3) years patient registration experience required strongly preferred. An equivalent combination of education and experience may be considered.
License/Certification
None required.
Other Qualifications
Effective verbal, written and interpersonal communication skills required. Must be able to effectively utilize Microsoft Office applications to perform work. Well developed problem solving and analytical skills required. Must be able to effectively prioritize workload amongst frequent interruptions with competing priorities. Knowledge of current coding rules and guidelines. Must possess a basic understanding of anatomy, physiology, disease process and medical terminology. Ability to coordinate work schedule with requirements of position (may include overtime and weekend work).
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