Pre Auth Financial Specialist

4 days ago

Laramie, Wyoming, United States Ivinson Memorial Hospital Full time

At Ivinson Memorial Hospital we are committed to excellence, trust, healing, and integrity. We pride ourselves in providing compassionate, world-class care to our community. At Ivinson we offer a competitive total rewards package including; full medical, dental, and vision insurance, retirement plans, paid time off and tuition reimbursement opportunities. Ivinson aims to improve the care provided for our patients and create a work-life balance for our employees by creating a culture of transparency, teamwork, accountability, and trust.

Base salary starts at $17.30/hr.

E S S E N T I A L F U N C T I O N S

  • Compiles and communicates accurate and pertinent clinical data and demographics to the patient's insurance company.
  • Keeps current on insurance regulations to obtain and record patient data; and maintain knowledge of system requirements.
  • Follow-up with insurance carriers to obtain certification/authorization numbers for outpatient services.
  • Performs on-line data entry of certification/authorization or denials and pre-authorization status.
  • Facilitates resolution of pre-authorization or referral issues for scheduled patients and same day add-ons to insure payment from the insurance company on the patient's behalf.
  • Works closely with Utilization Review to ensure all notifications, prior authorizations and continued stay reviews are completed as needed.
  • Coordinates with Social Worker when needed.
  • Ensures that all prior authorizations and ongoing authorizations documentation, databases, and records are maintained clearly and accurately, within a timely manner and meet HIPPAA requirements.
  • Coordinates peer to peer reviews with providers for denied requests.
  • Perform clinical reviews of authorization requests using appropriate criteria.
  • Serves as a resource for staff, APP's and physicians regarding prior authorizations.
  • Collaborates with clinical staff to resolve any problematic authorization issues.
  • Creates payment arrangement forms for uninsured patients and effectively communicates payment requirements to patients.
  • Ensures mail is documented and filed for all patient authorizations.
  • Performs other duties as assigned.
  • Demonstrates consistent use of AIDET (Acknowledge patient, Introduce yourself, provide duration/timeline for test, Explain the process & Thank them for choosing IMH) and HEAL (Hear them out, Empathize, Apologize, & Leap into action to solve) when interacting with patients/customers).
  • Collaborates with all departmental staff to facilitate timely patient care.
  • Participates in performance improvement activities.
  • Attends/participates in staff meetings, in-services, & facility wide meetings as scheduled.

E D U C A T I O N

  • High school diploma or equivalent required.
  • Clinical experienced preferred as a CNA, Medical Assistant, Patient Care Technician or Billing coder etc.

E X P E R I E N C E

  • Clinical experience preferred.
  • Previous experience in insurance verification preferred.

C R E D E N T I A L S

  • Must have current, valid Basic Life Support (BLS) certification or must obtain within 6 months of hire and maintain credentials throughout employment with IMH.

K N O W L E D G E , S K I L L S A N D A B I L I T I E S

  • Excellent customer service skills, including but not limited to: a friendly personality, tact, patience, empathy and a helpful, professional attitude both in person and on the telephone.
  • Ability to effectively communicate with staff, managers and the general public verbally and in writing.
  • Demonstrate effective listening skills.
  • Excellent organization and time management skills and ability to establish priorities effectively.
  • Possess exceptional problem solving skills.
  • Ability to work effectively without immediate supervision.
  • Ability to learn new computer software programs.
  • Ability to recognize and protect confidential information.
  • Demonstrate ethical and legal accountability for the position.

At Ivinson Memorial Hospital, we believe that our employees are our greatest investment. That's why we are committed to fostering a supportive, empowering environment where every team member has the resources and opportunities to thrive. We know that providing world-class healthcare starts with investing in our employees, ensuring they have the tools to grow, excel, and provide exceptional care.

Our competitive and comprehensive total rewards package includes:

For benefits eligible employees:

  • Medical, dental, and vision insurance
  • Paid time off: take the time you need to recharge
  • Retirement plans, including 403(b) matching
  • Employer-paid life and long-term disability insurance: Peace of mind for you and your family

For all employees:

  • Yearly work anniversary pay increases
  • Education Reimbursement; up to $2,500 annually
  • Retirement plan participation
  • Free certification classes: enhance your skills at no cost to you
  • Health and Wellness discounts at local gyms
  • Discounts at select mobile networks, local vendors, and Elitch Gardens
  • Mental Health: 6 free confidential, in-person counseling sessions offered by Pathways annually
  • Financial Counseling: free services through WellCents to help you take control of your financial journey
  • Legal assistance and will preparation services
  • Student Loan Forgiveness: Ivinson Memorial Hospital is a qualifying employer for the federal Public Service Loan Forgiveness (PSLF) program

Please use this link for more information regarding our rewards package and benefits: Benefits Guide.

At Ivinson Memorial Hospital, we are more than just a workplace – we are a community where your growth and well-being matter. Join us in making a difference in the lives of the Laramie community and help us provide world-class care.

Equal Opportunity Employer

This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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