PreAccess Authorization Specialist

15 hours ago

Frederick, United States Frederick Memorial Healthcare System Full time

Job Summary

Supports, and is responsible for incorporating into job performance, the Frederick Health (FH) mission, vision, core values and customer service philosophy and adheres to the FH Compliance Program, including following all regulatory requirements and the FH Standards of Behavior.

Responsible for verifying patient demographic and financial information for all insurances and self-pay accounts. Responsible for verifying insurance authorizations for in-patient and out-patient services. The primary function of the Pre-Access Authorization Specialist position is to provide premier customer service to all referring physician and their office staff by obtaining facility authorizations for all patients scheduled.

Example of Essential Functions:

* They must maintain extensive knowledge all areas of registration and scheduling including outpatient services, surgery and inpatient/observation stays.
* They will be required to verify insurance coverage and obtain insurance authorizations, notifications or referrals
* They are required to maintain a working knowledge of all insurance requirements for authorizations.
* They will maintain authorization performance statistics and report the results to management monthly.
* They will be required to meet and maintain the goals set forth by the Management Team.
* They will communicate status of authorizations to all parties.

Required Knowledge, Skills and Abilities:

* Proficiency in the use of computer software, ability to operate a copier, fax machine, 10 key calculator and printer.
* Excellent verbal and written communication skills in order to effectively interact with patients, customers, employees and Senior Leaders. Must demonstrate the ability to follow verbal and written instructions.
* Attention to detail, with the ability to analyze and determine the type of data needed to complete various types of patient registration functions.
* Must demonstrate ability to manage time, deadlines, multiple request and priorities, maintain productivity and exercise good judgment with minimal supervision.
* Must have the ability to apply policies and procedures regarding data security and confidentiality to prevent inappropriate release of patient information.

Minimum Education, Training, and Experience Required:

* High school diploma or GED required. Some college coursework preferred (Business/Health Sciences)
* One year hospital experience in the areas of registration and / or patient accounts or experience in a physician's office practice required.

Patient Contact

Must demonstrate and maintain current knowledge and skills in providing appropriate care/contact for patients in the following age groups:

_XPerformance of job does not require patient contact

Physical Demands:

Sedentary - Light Work - Lifting up to 15 pounds on an infrequent basis (less than one lift every three minutes). While work is mostly done sitting, a certain amount of walking or standing is often necessary.

Ergonomic Risk Factors:

Repetition: Repeating the same motion over and over again places stress on the muscles and tendons. The severity of risk depends on how often the action is repeated, the speed of the movement, the required force and muscles involved.

Awkward Posture: Posture is the position your body is in and its effect on the muscle groups that are involved in the physical activity. Awkward postures include repeated or prolonged reaching, twisting, bending, kneeling, squatting, working overhead with your hands or arms, or holding fixed positions.

Working Conditions:

A. Bloodborne Pathogens Exposure Risk: Category C - NO exposure to blood or body fluids.

Reporting Relationship:

Reports to Supervisor Insurance Authorization

Caring for you as you care for the CommUNITY

Frederick Health offers a comprehensive and affordable benefits package. Health, Dental and Vision insurance are offered the 1st of the month after 30 days of employment to all employees hired to work at least 20 hours per week and we offer multiple plans to best meet your and your family's needs. Life insurance, Short-Term Income Replacement and Long-Term Disability are employer paid for eligible employees. Frederick Health offers a robust Paid Time Off program for eligible employees. Our 403B retirement plan helps you save for your retirement and includes an employer match to eligible employees. All employees have access to free financial planning sessions. We also offer an educational assistance program to support your education goals as well as an employer paid Employee Assistance Program.

Pay is based on experience, skills and education. If position is part-time, salary will be pro-rated based on scheduled hours. The pay range may also vary within the stated range based on specialty if applicable. Non-Exempt positions may have shift differential and/or Overtime paid, if applicable.

Hourly Range: $17.29 - 25.60

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