Medical Authorization Specialist
3 weeks ago
The Authorization Specialist position at Saint Francis Medical Center is responsible for reviewing requests for prior authorization of medical services including elective and outpatient surgeries and procedures, home health, out-of-network requests, and expedited requests for medical necessity in accordance with government, commercial, and workers' compensation health plan coverage guidelines.
This position requires benefit determination and accurate documentation in accordance with healthcare system guidelines. The role involves working independently to solve problems and serves as a liaison with others outside the department to create smooth workflows and transitions of information needed for authorizations.
The ideal candidate will promote harmonious and efficient intra and interdepartmental relationships and deliver quality customer service. Additionally, they will adhere to the Mission, Vision, Values, and Philosophy of Saint Francis Medical Center.
Job Details and Requirements
Education:
High school graduate or equivalent is required.
Experience:
- One year of experience in a healthcare setting obtaining insurance authorizations is strongly preferred.
- Experience with CPT and ICD codes is a plus.
Equal Employment Opportunity:
Saint Francis Medical Center provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, sexual orientation, gender identity, or genetics. The organization complies with applicable state and local laws governing nondiscrimination in employment in every location.
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