Prior Authorization Specialist

Job Description

The Authorization Specialist evaluates medical services ordered for authorization requirements with payers and obtains authorization for diagnostic imaging, radiation therapy, oncology, rheumatology, and other services when necessary for reimbursement. Expectation is for all performed duties to be in accordance with Singing River Health System procedures and policies, accreditation organization, and governing guidance and publications for health care employees.

Qualifications

• High school diploma or equivalent required.
• Associates or bachelor’s degree in business finance, healthcare administration, or related field preferred.
• Certification as a Prior Authorization Certified Specialist through the National Board of Prior Authorization Specialists preferred.
• Must have de-escalation training completed by the end of position orientation (90 days); must have appropriate level of de-escalation training.
• Experience in a hospital or physician office setting obtaining authorizations for diagnostic imaging services or medical oncology services preferred.

Requirements

• Education: High school diploma or equivalent required. Associates or bachelor’s degree in business finance, healthcare administration, or related field preferred.
• Licenses: N/A
• Certifications: Certification as a Prior Authorization Certified Specialist through the National Board of Prior Authorization Specialists preferred.
• Experience: Experience in a hospital or physician office setting obtaining authorizations for diagnostic imaging services or medical oncology services preferred.

Skills

• De-escalation training completed by the end of position orientation (90 days).
• Knowledge of medical, coding, and billing terminology.
• Understanding of Revenue Cycle functions in a hospital setting.
• Working knowledge of MS Outlook, Word, Excel, and PowerPoint.
• Proficient knowledge and ability to use a computer (must be keyboard proficient) and other office technology (i.e., telephone, fax, etc.).
• Ability to navigate within an Electronic Medical Record (EMR).

Benefits

• Purposeful work in a supportive environment.
• Opportunities for growth and development.
• Collaborative and respectful working relationships.

Pay

N/A

Schedule

Monday - Thursday 7:30 am - 5:00 pm Fridays 8:00 am - 12:00 pm