Insurance Authorization Representative

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Education/Training:

• High School diploma or equivalent

Licenses/Certification:

• N/A  

Required Qualifications and Skills:

• Minimum of 1-3 years of experience in a health care related field.

  Interpersonal skills to effectively interact with patients, physician offices, insurance companies and departments throughout the hospital

• Excellent typing skills.
• Ability to use computer and office equipment.

Preferred Qualifications and Skills:

• Previous experience obtaining prior authorizations from payers
• Third party knowledge
• Business experience
• Healthcare terminology/knowledge
• Computer skills

Essential Job Functions:

(List the specific duties of this job – try to group, no more than 25):

• Run payer eligibility
• Call payers and/or electronically obtain prior authorization for departments within the hospital
• Work with outside offices to insure they are obtaining Prior Authorization
• Work closely with case management department to insure clinicals have been sent to the payer
• Run daily reports as required
• Call payers for follow-up on prior authorization status

Other duties: Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

AGE AND DIVERSITY RELATED CRITERIA: Consistently treats patients, colleagues and visitors with the dignity and respect, while being sensitive to the differing needs of all age groups, backgrounds, characteristics and cultures.

ABILITY TO FULFILL JOB EXPECTATIONS: Must have the ability to the perform essential functions of the position, including required work hours, locations and physical demands, without posing a direct threat to the health and safety of themselves or other individuals in the work place, and with or without reasonable accommodation.

PHYSICAL DEMANDS:

Prolonged periods of sitting at a desk and working on a computer.

Must be able to lift up to 15 pounds at times. 

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Salary Range Details

The pay range displayed on each job posting reflects the anticipated range for new hires. A successful candidate’s actual compensation will be determined after taking factors into consideration such as the candidate’s work history, experience, skill set, and education. This is not inclusive of the value Sturdy Health’s benefits package (if applicable), which includes among other benefits, healthcare/dental/vision and retirement. For annual salaries this is based on full-time employment.

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Sturdy Memorial Hospital is an equal employment opportunity employer. There is no discrimination because of race, color, creed, age, gender, sexual orientation, national origin, veteran status or disability.