PATIENT PROCESSING PRIOR AUTHORIZATION SPEC - HEART & LUNG S
POSITION SUMMARY
The PPS authorization specialist is responsible for ensuring an efficient, accurate, and complete pre-registration and/or authorization process for patients within East Alabama. This role involves verifying patient demographic and insurance information, obtaining timely insurance authorizations, pre-certifications, and referrals for scheduled and emergent services, and confirming insurance coverage prior to services being rendered. The specialist serves as a liaison between patients, providers, and insurance carriers to secure required approvals, explain benefits and out-of-pocket responsibilities, and ensure compliance with payer requirements. This position plays a critical role in preventing claim denials, supporting financial transparency for patients, and 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: N/A
- 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: N/A
OTHER REQUIREMENTS
N/A