PATIENT PROCESSING PRIOR AUTHORIZATION SPEC - EAMG PRE-REG

Position Summary

The PPS authorization specialist at East Alabama Medical Center is responsible for ensuring an efficient, accurate, and complete pre-registration and/or authorization process for patients. This role involves:

• Verifying patient demographic and insurance information
• Obtaining timely insurance authorizations, pre-certifications, and referrals for scheduled and emergent services
• Confirming insurance coverage prior to services being rendered
• Serving as a liaison between patients, providers, and insurance carriers to secure required approvals
• Explaining benefits and out-of-pocket responsibilities to patients
• Promoting compliance with payer requirements
• Preventing claim denials
• Supporting financial transparency for patients
• Promoting the delivery of uninterrupted, high-quality patient care

Position Qualifications

• Minimum Education: High School Diploma or equivalent
• Minimum Experience: 1-2 years customer service experience
• Required Registration/License/Certification: None
• Preferred Education: Associate Degree in Business or Health related field, Knowledge of Medical Terminology Preferred, Knowledge of ICD-10 and CPT coding preferred
• Preferred Experience: 1-2 years healthcare/hospital experience and/or customer service experience. 1-year computer experience and the ability to type and spell accurately. Insurance verification and authorization experience
• Preferred Registration/License/Certification: None
• Other Requirements: None