Pre-Arrival Authorization Specialist I

5 days ago


Goldsboro, North Carolina, United States UNC Health Full time
Job Summary

We are seeking a highly organized and detail-oriented Pre-Arrival Authorization Specialist I to join our team at UNC Health. As a key member of our Patient Access department, you will play a critical role in ensuring seamless patient experiences by obtaining authorizations from insurance payers prior to services being scheduled or rendered.

Key Responsibilities
  • Verify patient insurance coverage and obtain authorizations from payers via electronic means, phone, or the Electronic Health Record (EHR).
  • Process electronic referrals, address patient account issues, and respond to billing and insurance-related inquiries in a timely manner.
  • Prepare and send documents to insurance payers for pre-certifications and authorizations.
  • Update referral statuses and auth/cert status in EPIC.
  • Acknowledge and respond to requests for authorizations and retro authorizations.
  • Escalate matters requiring attention to the Pre-Arrival Team Lead/Manager.
  • Notify Utilization Review & Case Management regarding admissions requiring clinical review.
  • Adhere to UNC Health Wayne - Referral Management & Financial Clearance Collections Policies.
  • Provide exceptional customer service to patients and teammates.
Requirements
  • High School graduate or equivalent required.
  • Prior experience with preauthorizations/customer service, dealing with the public, and/or healthcare organizations is strongly preferred.
  • Computer literacy and proficiency with MS Office and Epic.
  • Ability to prioritize and multitask, with strong organizational skills and attention to detail.
  • Knowledge of Medicare/Medicaid and Commercial Insurance payers.
  • Effective oral and written communication skills in English.
  • Ability to work with deadlines and within timelines.
Working Conditions

This is a full-time position with a standard 40-hour workweek. The work schedule is day job, and the location is Wayne MED.



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