Marimn Health
All positions are filled based on Tribal Preference. We conduct pre-employment drug screening.
Start Over with Job Search Returning Applicant Login Now
AUTHORIZATION AND ELIGIBILITY SPECIALIST - OPEN IN-HOUSE THROUGH WEDNESDAY JULY 15TH 2026
Job Code 2026-MH-026
Location CLINIC
Preferred Experience Some Experience Required
Minimum Experience Job Category
Come work for Marimn Health - voted one of the Best Places to Work in the Inland Northwest every year since 2018 and Modern Healthcares Family Friendliest Employer in 2020
Fantastic benefits flexible schedules paid holidays and ability to choose vacation times
Your employer paid benefits include Medical Dental Prescription and Vision for employee and all legal dependents. 401k plan with 10 employer match after 1 year of employment. Employer paid life insurance. Short and long term disability. Generous PTO with the ability to earn additional personal days.
Please note that this position is in Plummer ID. Carpool opportunities are available.
QUALIFICATIONS A high school diploma or GED is required. One year of experience in a medical office or healthcare setting preferred. A minimum of one year of experience working with state federal or third-party payers required. This position requires a thorough understanding of multiple services benefits within the facility. A minimum of one-year prior experience working with a claims management system clinical electronic practice management or electronic health record system is required. Candidates must possess an understanding of all phases of patient eligibility benefits and prior authorizations process. All applicants must have verifiable successful records of the following tenacity customer service skills ability to work independently be detail oriented and patient focused. An understanding of FQHCTribal billing requirements desired.
ADA ESSENTIAL FUNCTIONS Hearing within normal limits with or without use of corrective hearing devices. Vision adequate to read 12-point type with or without use of corrective lenses. Must be able to verbally interact with staff clients and public. Manual dexterity of handsfingers for writing and data entry. Able to lift up to 25 lbs. Standing 25-75 of the day. Walking 25 of the day. Pushing up to 25 lbs. Pulling up to 25 lbs.
RESPONSIBILITIES Obtain prior authorizations for required services procedures devices and pharmaceuticals offered by Marimn Health including physical therapy services submit documentation needed. Track VA authorization end dates submit RFS renewals with required chart notes. Complete Medicaid Healthy Connections referrals. Coordinate with PRC on coverage issues and benefit updates. Explain insurance benefits coverage limitations and financial responsibilities in a clear supportive manner. Refer patients to Health Insurance Specialist andor Outreach and Enrollment Specialist for insurance updates or Alternate Resource needs. Refer patients to Outreach and Enrollment for Sliding Fee Program applications. Process Sliding Fee Applications during Idaho and Washington Open Enrollment period. Assist with payment arrangement discussions when appropriate. Ensure encounters have accurate payer information to prevent billing errors and denials. Collaborate with Revenue to resolve insurance- or authorization-related issues. Maintain required reports and tracking tools supporting accurate billing. Stay current on payer policy changes authorization rules and eligibility requirements. Maintain compliance with HIPAA confidentiality FQHCTribal billing rules and organizational policies. Review daily and upcoming schedules in Epic to ensure insurance information PCP assignments and benefits are accurate. Resolve Epic Real-Time Eligibility RTE errors and complete all items routed to Eligibility Work queues. Verify insurance eligibility using payer portals OneHealthPort Availity Noridian Idaho Medicaid HMA BCBS Idaho UHC Cigna etc. and by phone when required Dental. Document all eligibility and benefit information accurately in Epic confirming copays deductibles coinsurance out-of-pocket balances benefit limits and out-of-network coverage. Resolve assigned work queues in Epic daily. Participate in required training meetings and committees. Provide front desk coverage as needed including patient check-in answering and directing phone calls appointment scheduling and new patient registration. Perform other duties as assigned.