Prior Authorization Specialist

Singing River Health System

Pascagoula, Mississippi

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JOB DETAILS

SKILLS

Accreditation Standards, Billing, Communication Skills, Customer Support/Service, Data Processing, Detail Oriented, Electronic Medical Records, Establish Priorities, Federal Laws and Regulations, Finance, Government Organizations, Healthcare, Healthcare Administration, Hospital, Keyboards, Medical Billing, Medical Coding, Medical Imaging, Medical Office, Microsoft Excel, Microsoft Outlook, Microsoft PowerPoint, Microsoft Word, Multitasking, Office Equipment, Oncology, Patient Care Authorizations, Presentation/Verbal Skills, Publications, Radiation Therapy, Reimbursement, Rheumatology, Sales Closing Skills, Set Goals, State Laws and Regulations, Team Player, Time Management, Writing Skills

LOCATION

Pascagoula, Mississippi

POSTED

4 days ago

At Singing River Health System, caring isn't just part of the job - it's in our DNA. Whether we're saving lives, supporting behind the scenes, or showing up for our community, we bring the energy, heart, and hustle every single day.

With pride, passion, and commitment, we will improve health and save lives in our community every day.

Shift:
Monday - Thursday 7:30 am - 5:00 pm
Fridays 8:00 am - 12:00 pm

Location:
Singing River Pulmonary Services - Ocean Springs, Singing River Rheumatology Services - Pascagoula

Job Description Summary

Job Description

Position Overview:
The Authorization Specialist evaluates medical services ordered for authorization requirements with payers and obtains authorization for diagnostic imaging, radiation therapy, oncology, rheumatology, and other services when necessary for reimbursement.
Expectation is for all performed duties to be in accordance with Singing River Health System procedures and policies, accreditation organization, and governing guidance and publications for health care employees.

DISCLAIMER: This is not necessarily an exhaustive list of all responsibilities, duties, skills, efforts, requirements or working conditions associated with the job. While this intends to be an accurate reflection of the current job, management reserves the right to revise the job or to require that other or different tasks performed as assigned.

Education:
High School diploma or equivalent required. Associates or bachelor's degree in business finance, healthcare administration, or related field preferred.

License:
N/A

Certifications:
Certification as a Prior Authorization Certified Specialist through the National Board of Prior Authorization Specialists preferred.
Must have de-escalation training completed by the end of position orientation (90 days); must have appropriate level of de-escalation training.

Experience:
Experience in a hospital or physician office setting obtaining authorizations for diagnostic imaging services or medical oncology services preferred.

Reports to:
Patient Access Services Manager

Supervises:
N/A

Physical Demands:
Work involves moderate physical activity: frequently moving about the office, building, or other facilities within the SRHS service area; frequently positioning self to access files, computers, equipment, and other objects; performing repetitive motions with wrists, hands and fingers in using the keyboard and other office equipment.
Work involves being able to perceive the nature of sounds at normal speaking levels, with or without correction. Must demonstrate the ability to communicate, speak, and enunciate to express / exchange ideas and detailed information in person and on the telephone. Work requires a minimum standard of visual acuity, with or without correction, with the ability to adjust the eye to bring an object into sharp focus, i.e. shift gaze from viewing a computer monitor to forms that are closer to compare data at close vision.

Mental Demands:
Must demonstrate keen mental faculties/assessment and decision making abilities. Must demonstrate superior communication/speaking/enunciation skills to receive and give information in person and by telephone. Must demonstrate strong written and verbal communication skills. Must possess emotional stability conducive to dealing with high stress levels. Must demonstrate ability to work under pressure and meet deadlines.
Attention to detail and the ability to multi-task in complex situations is required. Must have the ability to maintain collaborative and respectable working relationships throughout SRHS and other organizations.

Special Demands:
Must possess superior customer service skills and professional etiquette. Must possess proficient knowledge and ability to use a computer (must be keyboard proficient) and other office technology (i.e., telephone, fax, etc.). Must have working knowledge of MS Outlook, Word, Excel, and PowerPoint.
Work requires the ability to function independently, adapt to workload demands, set priorities, and understand and set goals. Must understand the fundamentals of automated data processing, and be able to quickly gain a detailed understanding of complex computerized and non-computerized information.

Must possess knowledge of medical, coding, and billing terminology. Must have an understanding of Revenue Cycle functions in a hospital setting and thorough knowledge of state and federal laws, as they apply. Must be able to navigate within an Electronic Medical Record (EMR).

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About the Company

Singing River Health System

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