Authorization Specialist

Overview:

 

Benefits Statement

We offer:

Competitive Compensation

Generous benefits plan: Medical, Dental, Vision, 401K

Collaborative work teams & cohorts

…and much more

We would love to have you on our Team

 

Located in Gadsden, Alabama, Riverview Regional Medical Center is a 281-bed acute-care hospital serving more than 350,000 residents in Etowah and the contiguous counties. A full range of services and programs are offered, including the only accredited Cath Lab in Northeast Alabama, Sleep Lab, Wound Care and Hyperbaric Center, and Women’s Diagnostic Imaging Center. Riverview Regional Medical Center is accredited by The Joint Commission (TJC) and is rated among the top 5% of hospitals in the nation for patient safety. Riverview is also the areas highest rated hospital, receiving Four-Stars from the Centers for Medicare and Medicaid (CMS). Originally named Holy Name of Jesus Hospital, Riverview Regional Medical Center was founded in 1917 by the Sisters of the Missionary Servants of the Most Blessed Trinity.  Riverview was purchased by Prime Healthcare in 2016.  Together they continue a mission of providing quality healthcare in the community it so proudly serves. To learn more about Riverview Regional Medical Center and the services it provides, visit

 

We are an Equal Opportunity Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation, or other protected characteristics.  If you need special accommodation for the application process, please contact Human Resources.  Know Your Rights: 

Responsibilities:
The Hospital Authorization Specialist reviews databases and other pertinent documentation to ensure all needed pre-certifications and/or authorizations are completed for medical services. Works with all clinics and appropriate ancillary departments to ensure requirements are met through training, education and consultation. Must be familiar with and remain current of insurance carriers and requirements to include a working knowledge of referral and pre-certification processes and medical necessity guidelines. Must demonstrate exceptional customer service to patients, referring sources both internal and external. This position requires the ability to effectively communication information to the patient related to testing, required preparations and financial obligations.
 

Qualifications:
EDUCATION, EXPERIENCE, TRAINING
 
1. Knowledge of standard insurance companies and verification requirements.
2. Well versed in authorization processes for all payers
3. Knowledge of medical terminology
4. Basic computer skills
5. Knowledge of Common Procedural Terminology (CPT), ICD codes
6. Ability to multi-task, prioritize needs to meet required timelines
7. Analytical and problem-solving skills
8. Customer Services experience required
9. High School Graduate or GED Equivalent required (effective 4/1/14 for all new hires)
10. 3-5 years pre-certification processes and medical necessity guidelines preferred

 

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