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Prior-Authorization Specialist | Fulton Street | Beacon Medical Group

Company: Beacon Health System
Location: elkhart
Posted on: May 3, 2021

Job Description:

JOB SUMMARY Reports to the Centralized Operations Manager and works under the direction of the Centralized Office Supervisor under general supervision and according to established policies and procedures. Responsibilities include scheduling specialty and/or diagnostic procedures to ensure the customer#s next step(s) in care are well coordinated within Beacon Health System whenever possible. Communicating with empathy and clarity regarding the details of the next step in care for the customer. Obtains prior authorizations as necessary to ensure reimbursement occurs at the highest possible level to assist in prevention of prior authorization denials. MISSION # VISION Mission:#To enhance the physical, mental and emotional well-being of the communities we serve as the community#s provider of outstanding quality, superior value and comprehensive health care services. Vision:#Our vision is to achieve: Innovative health care and well-being services of the highest quality at the greatest value Easy access and convenience Outstanding patient experiences Ongoing education involving physicians, patients and the community JOB SPECIFICATIONS Education and Experience The knowledge, skills and abilities as indicated are normally acquired through the successful completion of a high school diploma or equivalent; successful completion of an approved Medical Assistant Program with successful completion of the Certification Exam or equivalent medical office experience. Medical terminology, ICD-10, CPT, / prior authorizations, and specialty/diagnostic referral experience required Working knowledge of Microsoft Office: Outlook, Excel and Word. Knowledge # Skills Demonstrates well developed communication skills to communicate effectively and clearly to a variety of internal and external contacts. Demonstrates analytical skills necessary to solve problems and interpret data. Promotes collaboration and innovation in the clinical services to ensure an interdisciplinary approach to improving healthcare delivery and the quality of patient care. Must be tactful in handling patient problems often of a highly personal and confidential nature. Must be able to maintain professionalism during potential frustrating interpersonal situations. Demonstrates a high knowledge level of procedures; including knowledge of CPT codes and ICD-10 Codes. Demonstrates a working knowledge (referrals) high knowledge (prior authorization) of insurance network guidelines to ensure the referral is scheduled in accordance with customer#s insurances rules and regulations Working Conditions Assigned hours within your shift, starting time, or days of work are subject to change based on departmental and/or organizational needed. May need to travel to other Beacon locations. Working space is frequently congested by other personnel. Constantly exposed to noise and distraction. Physical Demands Requires the physical ability and stamina to perform the essential functions of the position. Sitting for long periods of time in front of a computer monitor

Keywords: Beacon Health System, Elkhart , Prior-Authorization Specialist | Fulton Street | Beacon Medical Group, Other , elkhart, Indiana

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