Prior Authorization Specialist

Lake Regional Health System is looking for a dedicated, professional Prior Authorization Specialist to join our Home Health team. With our state-of-the-art hospital and network of clinics, therapy sites, and pharmacies, Lake Regional offers a wide range of employment opportunities in our community.

Key Responsibilities

• Promotes customer satisfaction through competent professional practice and focus on patient needs and expectations.
• Effectively facilitates the coordination of the continuum of patient care in a timely, caring manner, including but not limited to Prior Authorizations, verification of patient’s insurance coverage, and financial forms.
• Acts as a liaison with all insurance personnel in obtaining referral authorizations.
• Research hospice bills, processing Hospice Medicaid regulatory forms
• Communicate with patients regarding insurance coverage and authorizations
• Assist patients with financial assistance
• Serve as a subject-matter expert, including participating in projects and providing input on process improvement, marketing, etc.
• Answering phones
• Participate in leadership meetings, documentation of meeting minutes
• Ordering, stocking, and inventory of medical and office supplies expiration date checks,
• Cross-trained to work in the role of Intake Registrar on 1-2 weekends each month

Qualifications

• High School graduate/GED
• Knowledge of medical terminology and health insurance processes preferred
• Experience with Electronic Medical Records helpful
• Ability to work on a computer and compose letters
• Excellent professional communication abilities, at all levels within the organization and with patients, at all times
• Annual influenza vaccine required.

Additional certifications may be required for this position and will be coordinated by Lake Regional as a part of your ongoing training and development. Please contact your recruitment team for more details.
Opportunity Features: We offer a competitive compensation package including excellent benefits such as:

• Health, Dental, Vision insurance and supplemental policies
• Employer-sponsored Life and AD&D insurance 
• Employee Assistance Program (EAP)
• Flexible Spending Accounts
• 401K with a company match
• Paid Time Off (PTO)
• Tuition assistance and continuing education opportunities
• Area discounts
• And so much more!

 If you’d like to be a part of a team setting that fosters excellence, apply now!