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SalaryJob Title: Pre-Authorization Specialist
Location: Bend
Hours: 40 hours per week; 8-hour days; Monday-Friday (hours TBD during training period); 9:00AM - 6:00PM after training period.
Wages: Starting at $20.97 per hour; DOE, education and internal equity of current employees
Position Type: Full Time, non-exempt
Benefits: Medical, Dental, Vision, 401K Retirement, Paid Time Off, Sick Time Off
Resume Required: Yes
Date Posted: 02/13/2024
Posting Expires: Open until filled
Location: Bend
Hours: 40 hours per week; 8-hour days; Monday-Friday (hours TBD during training period); 9:00AM - 6:00PM after training period.
Wages: Starting at $20.97 per hour; DOE, education and internal equity of current employees
Position Type: Full Time, non-exempt
Benefits: Medical, Dental, Vision, 401K Retirement, Paid Time Off, Sick Time Off
Resume Required: Yes
Date Posted: 02/13/2024
Posting Expires: Open until filled
Job Description: Expedites the administrative requirements for patient referrals, dealing directly with health plans and or referring physicians’ offices, ensuring proper notification / authorization have been obtained in a timely manner.
Reports To: Chief Outpatient Operations Officer and Scheduling Manager
Supervision Exercised: None
Education and Experience: High school diploma or GED equivalent. One year certificate from college or technical school; or three to six months related experience and/or training; or equivalent combination of education and experience.
Essential Duties: This position requires regular, reliable attendance. This position requires a high level of attention to detail and accuracy, as the consequences of even a minor mistake can be significant for patients and providers. Other duties as assigned.
- Verifies and validates insurance pre-authorization number with appropriate carrier to ensure prior approval requirements are met.
- Confirms facility matches the authorization.
- Confirms the CPT code is specific to the exam.
- Communicates information effectively both verbally and in writing.
- Contact person for procedures that are changed or added during a patient’s appointment so appropriate authorization can be made while the patient is here.
- Submit and/or correct prior authorization requests to insurance companies utilizing chart notes and other resources
- When an e-mail is received from the scheduling department regarding add-on studies, authorization is obtained when needed and in a timely manner.
- Verifies authorizations are in place for all PET scans prior to arrival.
- Contacts referring physician’s office with insurance denials and works with them to make any necessary corrections.
- Contacts patient prior to services being rendered if an authorization is denied or has not yet been obtained to advise them of the reason(s) and to advise them to our fees for the procedure(s).
- Ability to get along with others and work cohesively with co-workers.
EEOC Statement:
CORA is committed to providing employees with a work environment that is free of discrimination and harassment. CORA advocates achieving a diverse workforce through application of its equal opportunity and nondiscrimination policy in all aspects of employment including recruitment, hiring, promotions, transfers, discipline, terminations, wage and salary administration, benefits, and training. All employment decisions are based on business needs, job requirements and individual qualifications without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, and veteran or disability status. Reasonable accommodation can and will be provided to any employee who needs accommodation to perform the essential functions of the job if the accommodation does not cause undue hardship.
