Fisher-Titus Medical Center
Prior Authorization Specialist I
Fisher-Titus Medical Center, Norwalk, Ohio, United States, 44857
Caring For the Community You Love
Choose a career to make a difference in people's lives every day, choose Fisher‑Titus!
Position Summary The Prior Authorization Specialist I is responsible for ensuring that payers are prepared to reimburse Fisher‑Titus for services in accordance with the payer‑provided contract. The Specialist contacts payers to request service authorization and may collect financial and/or demographic information from patients as needed.
Essential Functions
Verifies patients’ insurance and benefits information
Obtains prior authorization from third‑party payers in accordance with payer requirements
Contacts patients to gather demographic and insurance information as needed, and updates patient information within the EMR as necessary
Works with other departments to gather the clinical information required by the payer to authorize services
Maintains accurate records of authorizations within the EMR
Identifies patients who will need to receive Medicare Advance Beneficiary Notices of Noncoverage (ABNs)
Refers accounts to financial counseling as needed if authorization is not obtained
Works directly with and supports the needs of the Denial/Appeals committee
Complies with HIPAA regulations, as well as the organization's policies and procedures regarding patient privacy and confidentiality
Continually maintains professional tone when communicating with patients and payer representatives
Performs other clerical duties as requested
Benefits & Work Hours
Full‑time hours
Comprehensive benefits package – medical & dental coverage, 401(k) match, paid time off, tuition assistance, and more
Shift, weekend & PRN differential
Location Willard, OH
#J-18808-Ljbffr
Position Summary The Prior Authorization Specialist I is responsible for ensuring that payers are prepared to reimburse Fisher‑Titus for services in accordance with the payer‑provided contract. The Specialist contacts payers to request service authorization and may collect financial and/or demographic information from patients as needed.
Essential Functions
Verifies patients’ insurance and benefits information
Obtains prior authorization from third‑party payers in accordance with payer requirements
Contacts patients to gather demographic and insurance information as needed, and updates patient information within the EMR as necessary
Works with other departments to gather the clinical information required by the payer to authorize services
Maintains accurate records of authorizations within the EMR
Identifies patients who will need to receive Medicare Advance Beneficiary Notices of Noncoverage (ABNs)
Refers accounts to financial counseling as needed if authorization is not obtained
Works directly with and supports the needs of the Denial/Appeals committee
Complies with HIPAA regulations, as well as the organization's policies and procedures regarding patient privacy and confidentiality
Continually maintains professional tone when communicating with patients and payer representatives
Performs other clerical duties as requested
Benefits & Work Hours
Full‑time hours
Comprehensive benefits package – medical & dental coverage, 401(k) match, paid time off, tuition assistance, and more
Shift, weekend & PRN differential
Location Willard, OH
#J-18808-Ljbffr