MV INFUSION - INSURANCE PRE-AUTHORIZATION SPECIALIST

About the role

Checks appointments and tasks/messages to make sure the diagnosis/documentation will support medical necessity, as per insurance company, and verifies that all office visits and procedures that need preauthorization are pre-authorized. Works closely with referring offices to be used as a resource in helping them get necessary paperwork to start pre-authorizations, prove medical necessity, or to perform a retro-authorization. Works closely with co-workers and vendor representatives to get visits/procedures approved.

Responsibilities

• Checks appointments and tasks/messages to ensure medical necessity and pre-authorization requirements are met.
• Works with referring offices to provide necessary paperwork and assistance with pre-authorizations.
• Collaborates with co-workers and vendor representatives to secure approvals for visits and procedures.

Requirements

• High School graduate or equivalent.
• Prior experience with coding and billing for outpatient billing is preferred.
• Knowledge of diagnoses and CPT codes for authorizing infusion services is preferred.
• Ability to communicate well with patients, co-workers, and vendor representatives.
• Continuously able to concentrate on fine detail with interruptions and continuously able to attend to task/function for an extended period of time.
• Ability to learn computer programs and input data as required.
• Interpersonal skills to work well with others.
• Writing and phone etiquette necessary to properly submit preauthorization requests with insurance companies.
• Judgment, tact, and diplomacy to effectively resolve conflicts.

Qualifications

• High School graduate or equivalent.
• Prior experience with coding and billing for outpatient billing is preferred.
• Knowledge of diagnoses and CPT codes for authorizing infusion services is preferred.

Skills

• Excellent communication skills.
• Ability to work well with others.
• Strong attention to detail.
• Effective problem-solving and conflict resolution skills.

Benefits

• Medical, Dental, and Vision Insurance.
• Paid Time Off (vacation, holidays, and sick days).
• Medical Paid Time Off.
• Retirement Plans (401K with up to 6% match).
• Earned Quarterly Bonus Program.
• Education Reimbursement Program.
• Discount for medically necessary procedures performed at Mountain View Hospital and Idaho Falls Community Hospital.

Pay

TBD

Schedule

TBD