Health Information Specialist

About the role

Pacific Neuropsychiatric Specialists (PNS) is a leading mental health medical group dedicated to providing comprehensive treatment for a wide range of mental health conditions, including ADHD, depression, anxiety, bipolar disorder, schizophrenia, dementia, and more. Our services span adolescent and adult psychiatry, medication management, and psychotherapy. We are seeking a motivated and like-minded Health Information Specialist for a full-time, in-office position.

Responsibilities

• Manage and maintain the accuracy, security, and privacy of electronic and paper-based medical records.
• Ensure data quality and compliance with legal and industry standards.
• Assist with the prior authorizations department by discussing medications, insurance, and prior authorization documents with patients.
• Obtain prior authorization approval from insurance companies, file appeals, and ensure completeness and accuracy on all prior authorizations.
• Submit requests to insurance companies, gather necessary documents, complete forms, and follow up on the status of the requests.
• Provide updates on the authorization, review requests for completeness, and ensure all supporting documents are submitted to expedite approvals.
• Receive requests for prior authorizations and ensure they are properly and closely monitored within company-set standards.
• Review the accuracy and completeness of the information requested and ensure all supporting documents are present.
• Assist with medical necessity documentation to expedite approvals and ensure appropriate follow-up is completed.
• Collaborate with other departments to assist in obtaining prior authorizations/appeals.
• Document all interactions with insurance companies within the EMR system.
• Proactively work on prior authorizations that are due to expire.
• Complete all required duties, projects, and reports in a timely fashion on a daily, weekly, or monthly basis per the direction of leadership.
• Perform other duties as assigned.

Requirements

• Previous experience working in a medical/psychiatric facility is preferred.
• Excellent communication skills, both written and oral.
• Proficient telephone and computer skills.
• Ability to prioritize multiple tasks at once and manage high stress levels in an environment of changing priorities.
• Ability to interact professionally with all levels of staff.
• Medical Records and Prior Authorization experience preferred, but not required.

Benefits

• Health insurance
• Paid time off
• Vision insurance
• 401(k) matching
• Dental insurance

Pay

Hourly rate based on skill, experience, and tenure.