BJC HealthCare
Prior Authorization Rep - PRN
Mid Campus Center is looking to hire a PRN Prior Authorization Rep for their Ambulatory Services.
Additional Preferred Requirements
Day time PRN Shift
Working hours 8-5.
There is flexibility with start time
This person will cover PTO and FMLA, and fill‑in when needed
Prefer prior authorization experience, EPIC, and insurance experience
Daily Pay
Role Purpose This role is critical in the financial clearance process which assists BJC hospitals enterprise wide in securing the appropriate authorization and/or Notice Of Admission (NOA) to prevent rescheduling the patient or risking net revenue loss. The position is required to obtain authorization on behalf of some physicians at Washington U School of Medicine and BJC medical group and must maintain positive relationships. It ensures technology is built in a way to accurately support the scripting and validation of authorization and NOA. Without this, collection of payment is limited. The role represents BJC with the highest standard of customer service, compassion and performing all duties consistently with BJC mission, vision, values, and service standards. It facilitates certain components of the patients’ entrance into any BJC facility, including insurance validation, benefit verification, pre‑certification & financial clearance. The role is responsible for ensuring that the most accurate patient data is obtained and populated into the patient record, particularly authorization data and status.
Responsibilities Requires a high level of attention to detail and a high degree of accuracy. Key components of the process include validation of patient information, scheduled test/surgery information, and insurance information. Ensures that the authorization detail placed in the patient’s medical record is accurate. Expected to utilize critical thinking skills to research and resolve any mismatch in information which may involve various orders/scheduling, registration and insurance systems. The position follows departmental processes around data capture and communicates effectively with provider offices, insurance companies, and patients (typically phone calls for rescheduling appointments). The team member must provide consistent excellent customer service, promote teamwork and employee engagement, and seek opportunities for self‑development while achieving departmental objectives. This position may support Ancillary Authorization, Surgery Authorization, or NOA processes within the BJC Pre‑Arrival Team and may involve reviewing medical records for payer authorization requests. This is a safety‑sensitive position requiring constant alertness and safe work methods.
Minimum Requirements Education
High School Diploma or GED
Experience
2-5 years
Preferred Requirements Education
Associate’s Degree
Experience
5-10 years
Licenses & Certifications
CHAA
Benefits and Legal Statement BJC Total Rewards: At BJC we’re committed to providing you and your family with benefits and resources to help you manage your physical, emotional, social, and financial well‑being.
Comprehensive medical, dental, vision, life insurance, and legal services available first day of the month after hire date
Disability insurance paid for by BJC
Annual 4% BJC Automatic Retirement Contribution
401(k) plan with BJC match
Tuition Assistance available on first day
BJC Institute for Learning and Development
Health Care & Dependent Care Flexible Spending Accounts
Paid Time Off benefit combines vacation, sick days, holidays and personal time
Adoption assistance
Not all benefits apply to all jobs. Equal Opportunity Employer.
#J-18808-Ljbffr
Additional Preferred Requirements
Day time PRN Shift
Working hours 8-5.
There is flexibility with start time
This person will cover PTO and FMLA, and fill‑in when needed
Prefer prior authorization experience, EPIC, and insurance experience
Daily Pay
Role Purpose This role is critical in the financial clearance process which assists BJC hospitals enterprise wide in securing the appropriate authorization and/or Notice Of Admission (NOA) to prevent rescheduling the patient or risking net revenue loss. The position is required to obtain authorization on behalf of some physicians at Washington U School of Medicine and BJC medical group and must maintain positive relationships. It ensures technology is built in a way to accurately support the scripting and validation of authorization and NOA. Without this, collection of payment is limited. The role represents BJC with the highest standard of customer service, compassion and performing all duties consistently with BJC mission, vision, values, and service standards. It facilitates certain components of the patients’ entrance into any BJC facility, including insurance validation, benefit verification, pre‑certification & financial clearance. The role is responsible for ensuring that the most accurate patient data is obtained and populated into the patient record, particularly authorization data and status.
Responsibilities Requires a high level of attention to detail and a high degree of accuracy. Key components of the process include validation of patient information, scheduled test/surgery information, and insurance information. Ensures that the authorization detail placed in the patient’s medical record is accurate. Expected to utilize critical thinking skills to research and resolve any mismatch in information which may involve various orders/scheduling, registration and insurance systems. The position follows departmental processes around data capture and communicates effectively with provider offices, insurance companies, and patients (typically phone calls for rescheduling appointments). The team member must provide consistent excellent customer service, promote teamwork and employee engagement, and seek opportunities for self‑development while achieving departmental objectives. This position may support Ancillary Authorization, Surgery Authorization, or NOA processes within the BJC Pre‑Arrival Team and may involve reviewing medical records for payer authorization requests. This is a safety‑sensitive position requiring constant alertness and safe work methods.
Minimum Requirements Education
High School Diploma or GED
Experience
2-5 years
Preferred Requirements Education
Associate’s Degree
Experience
5-10 years
Licenses & Certifications
CHAA
Benefits and Legal Statement BJC Total Rewards: At BJC we’re committed to providing you and your family with benefits and resources to help you manage your physical, emotional, social, and financial well‑being.
Comprehensive medical, dental, vision, life insurance, and legal services available first day of the month after hire date
Disability insurance paid for by BJC
Annual 4% BJC Automatic Retirement Contribution
401(k) plan with BJC match
Tuition Assistance available on first day
BJC Institute for Learning and Development
Health Care & Dependent Care Flexible Spending Accounts
Paid Time Off benefit combines vacation, sick days, holidays and personal time
Adoption assistance
Not all benefits apply to all jobs. Equal Opportunity Employer.
#J-18808-Ljbffr