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Prior Authorization Specialist

2 months ago

St Louis, Missouri, United States BJC Full time
About the Role

BJC HealthCare is seeking a skilled Prior Authorization Specialist to join our team. As a key member of our Pre-Arrival Team, you will play a critical role in securing authorization and/or Notice Of Admission (NOA) for patients, ensuring timely and accurate financial clearance.

Key Responsibilities
  • Validate patient information, scheduled test/surgery information, and insurance information to ensure accurate authorization detail in the patient's medical record.
  • Utilize critical thinking skills to research and resolve any mismatches in information, involving various orders/scheduling, registration, and insurance systems.
  • Communicate effectively with provider offices, insurance companies, and patients, providing positive and respectful interaction and consistent excellent customer service.
  • Work collaboratively with the multidisciplinary team to provide authorization support for multiple BJC Hospitals, including Ancillary Authorization, Surgery Authorization, and NOA processes.
Requirements
  • High School Diploma or GED
  • 2-5 years of experience in prior authorizations for medications
  • Preferred: Associate's Degree and 5-10 years of experience
What We Offer

BJC Total Rewards provides comprehensive benefits and resources to support your physical, emotional, social, and financial well-being. This includes medical, dental, vision, life insurance, and legal services, as well as disability insurance, pension plan, 401(k) plan, tuition assistance, and more.