Prior Authorization & Referral Specialist - Webster City Clinic, Full Time

We need to output only HTML fragment with sections as per rules. Must include only sections with real content. No job title heading. No Job ID. Remove boilerplate like HomeCareers Date Posted etc. We need to extract details: location, type, department, maybe schedule? The posting says "9 FTE Monday-Friday between the hours of 7:00am and 5:00pm." That's schedule info. So we can include a Schedule section with that. Benefits? Not mentioned. Pay? Not mentioned. So only include sections that have content: About the role? The job details description is essentially responsibilities. Could use "Responsibilities" heading for the list of duties. Also "Requirements" for education, experience, etc. Possibly "Skills" for additional skills. Could also have "Qualifications" but we can combine. The instruction: use

for section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule). So we can choose appropriate headings. We need to preserve all substantive information. So we need to include location, department, type, maybe as a short paragraph before sections? The instruction: do NOT put Job ID / requisition numbers as headings — fold minor metadata into a short

or drop it. So we can include a

with location, department, type, date posted? The date posted maybe minor metadata; we can include in a short p. But we should not repeat job title. So we can start with a

containing: Posted September 17, 2026 • Full Time • Human Resources • Van Diest Medical Center, 2350 Hospital Drive, Webster City, IA 50595. Then sections: Responsibilities (list of duties). Requirements (education, experience, etc). Skills (additional skills and abilities). Schedule (9 FTE Monday-Friday 7am-5pm). Possibly Benefits? Not present, so omit. We must not invent or summarize away detail. Must preserve all substantive info. So we need to include all duties listed. That's a long paragraph with repeated sentences. We need to convert to list items (

• ). Must preserve all info; we can split into logical items but must not lose detail. Could create multiple
• each covering a distinct duty. Ensure we capture all points. Let's extract duties from the "Job Details" paragraph: - obtains precertification authorization from insurance companies for patients with scheduled surgical procedures, and various tests, including MRIs, CTs, and Sleep studies. - identifies and contacts patient’s insurance company for eligibility, pre-existing, and exclusions; - provides patient’s medical history, treatments received, current conditions, and planned surgical treatment. - Determines if prior approval is needed and notifies the appropriate department staff of outcome and the patient, when necessary. - Obtains precertification, prior approval, or pre-determination authorization for scheduled tests and surgical procedures by contacting patient’s insurance company, including workman’s compensation carriers, for eligibility, pre-existing, or exclusions; provides patient’s medical history, treatments received, current conditions, and planned testing or surgical treatment. - Determines if prior approval is needed and notifies the appropriate department staff of outcome and the patient when necessary. - In doing so either contacts insurance company by phone, fax or completes documentation via on line computer form with pertinent information including patient history, diagnosis, current symptoms. - Assists in answering patient questions when they present regarding insurance coverage for a procedure and if authorization is required, or will direct accordingly. - Notifies appropriate Business Office staff of any possible problems in payment for a procedure, i.e. no insurance or non-covered procedures or services. - Documents in the computer system the precertification, prior approval or pre-determination authorization information from the insurance company. - Interacts with physicians, nurses, coders, and other Clinic staff to gather patient information needed for precertification, prior approval, or pre-determination process. - Schedules referral appointments with specialists, as ordered - Schedules routine and follow up appointments for patients as needed - Updates patient demographics if inaccuracies are found. - Abides by the Standards of Conduct. - Follows all infection control, safety and general hospital policies and submits all follow up paperwork to human resources, employee health and all other departments as requested in the time allowed. - Completes all required competencies. - Maintains a written log of all important information and activity to keep an accurate record to verify actions taken - Communicates messages and important information to fellow employees and supervisor through the email, phone, or in-person at shift change. - Email will remain open throughout shift, and employee will read and respond to emails in a prompt manner - Participates in all quality assurance activities, documentation, data collection and other training as requested. - Utilizes computer hardware and software or other computer based equipment in performing most essential functions of the job. - Works to maximize office efficiency. - Maintains organized and neat work area. - Maintains current level of knowledge and skill related to education, tools equipment. - Participates on various Hospital committees, when assigned and completes assignments within given time. - Other duties as assigned. We need to ensure we don't duplicate similar items. There's repetition: obtains precertification authorization appears twice with slight variation. We could combine but must preserve all info; merging might lose nuance but likely acceptable as preserving substantive info? The instruction: "Preserve ALL substantive information; do NOT invent or summarize away detail." Merging could be considered summarizing away detail if we lose specifics. Safer to keep both as separate items, even if similar. We'll create
  • for each duty. Now Requirements section: Education: High school diploma or GED required. Must be able to speak, hear and understand the English language. Experience: Minimum of 2 years computerized data entry experience required. Reception or clerical experience at a healthcare setting is preferred. Proficiency in use of Microsoft Office applications, specifically Word and Excel, e-mail, and internet/web searches is preferred. Knowledge of computer to research, input, update information pertinent to specific tasks. Interpersonal skills necessary in order to deal effectively with physicians, clinic personnel, insurance company representatives and patients in exchanging patient information to obtain precertification authorization. We can break into list items. Additional Skills and Abilities: Knowledge of basic anatomy, physiology, coding and medical terminology in order to interpret patient history and treatments at a level normally acquired through completion of a one year medical assistant or medical secretary program. Ability to concentrate and pay close attention to detail when reviewing patient medical record, insurance information, and entering data into the computer system which occupies approximately 75-80% percent of work time. We can put these under Skills section. Schedule: "9 FTE Monday-Friday between the hours of 7:00am and 5:00pm." We'll put as

    maybe inside Schedule section? The instruction: use

    for section headings and

    • for any list of duties/requirements/benefits, and

      for prose. So Schedule is not a list; we can put a

      under

      Schedule

      . Now we need to output only HTML fragment, no /. We'll start with maybe a

      for metadata then sections. Let's craft:

      Posted September 17, 2026 • Full Time • Human Resources • Van Diest Medical Center, 2350 Hospital Drive, Webster City, IA 50595

      Responsibilities

      • Obtains precertification authorization from insurance companies for patients with scheduled surgical procedures, and various tests, including MRIs, CTs, and Sleep studies.
      • Identifies and contacts patient’s insurance company for eligibility, pre-existing, and exclusions.
      • Provides patient’s medical history, treatments received, current conditions, and planned surgical treatment.
      • Determines if prior approval is needed and notifies the appropriate department staff of outcome and the patient, when necessary.
      • Obtains precertification, prior approval, or pre-determination authorization for scheduled tests and surgical procedures by contacting patient’s insurance company, including workman’s compensation carriers, for eligibility, pre-existing, or exclusions; provides patient’s medical history, treatments received, current conditions, and planned testing or surgical treatment.
      • Determines if prior approval is needed and notifies the appropriate department staff of outcome and the patient when necessary.
      • Contacts insurance company by phone, fax or completes documentation via online computer form with pertinent information including patient history, diagnosis, current symptoms.
      • Assists in answering patient questions regarding insurance coverage for a procedure and if authorization is required, or directs accordingly.
      • Notifies appropriate Business Office staff of any possible problems in payment for a procedure, i.e., no insurance or non-covered procedures or services.
      • Documents in the computer system the precertification, prior approval or pre-determination authorization information from the insurance company.
      • Interacts with physicians, nurses, coders, and other Clinic staff to gather patient information needed for precertification, prior approval, or pre-determination process.
      • Schedules referral appointments with specialists, as ordered.
      • Schedules routine and follow up appointments for patients as needed.
      • Updates patient demographics if inaccuracies are found.
      • Abides by the Standards of Conduct.
      • Follows all infection control, safety and general hospital policies and submits all follow up paperwork to human resources, employee health and all other departments as requested in the time allowed.
      • Completes all required competencies.
      • Maintains a written log of all important information and activity to keep an accurate record to verify actions taken.
      • Communicates messages and important information to fellow employees and supervisor through email, phone, or in-person at shift change.
      • Email remains open throughout shift; employee reads and responds to emails in a prompt manner.
      • Participates in all quality assurance activities, documentation, data collection and other training as requested.
      • Utilizes computer hardware and software or other computer based equipment in performing most essential functions of the job.
      • Works to maximize office efficiency.
      • Maintains organized and neat work area.
      • Maintains current level of knowledge and skill related to education, tools equipment.
      • Participates on various Hospital committees, when assigned and completes assignments within given time.
      • Performs other duties as assigned.

      Requirements

      • High school diploma or GED required.
      • Must be able to speak, hear and understand the English language.
      • Minimum of 2 years computerized data entry experience required.
      • Reception or clerical experience at a healthcare setting is preferred.
      • Proficiency in use of Microsoft Office applications, specifically Word and Excel, e-mail, and internet/web searches is preferred.
      • Knowledge of computer to research, input, update information pertinent to specific tasks.
      • Interpersonal skills necessary in order to deal effectively with physicians, clinic personnel, insurance company representatives and patients in exchanging patient information to obtain precertification authorization.

      Skills

      • Knowledge of basic anatomy, physiology, coding and medical terminology in order to interpret patient history and treatments at a level normally acquired through completion of a one year medical assistant or medical secretary program.
      • Ability to concentrate and pay close attention to detail when reviewing patient medical record, insurance information, and entering data into the computer system which occupies approximately 75-80% of work time.

      Schedule

      9 FTE Monday-Friday between the hours of 7:00am and 5:00pm.

      We should ensure no extra sections like Benefits, Pay. Also we included metadata paragraph. Ensure no markdown fences. Output only HTML. Check for any repeated content: we have two similar items