Prior Authorization Specialist

Position Summary

As the Prior Authorization Specialist, you will monitor incoming orders and gathers necessary documentation to ensure pre-certification, authorization, and referral requirements are met prior to the delivery of inpatient, outpatient, and ancillary services.

Key Responsibilities:

• Works with insurance companies and staff to obtain initial and ongoing authorizations for patients in advance of services.
• Reviews accuracy and completeness of information requested to ensure that all supporting documents are present
• Provides feedback to referring provider office so patient services can be scheduled
• Provides authorization number to internal teams (providers, billers, etc.)
• Researches, corrects, and resubmits rejected/denied insurance authorizations
• Communicates with patients, clinic personnel, and providers over the phone, via email or other written documentation and responds to all inquires
• Utilizes and maintains online Prior Authorization software

Selection Criteria:

• High School diploma or equivalent
• Effective communication skills, both verbal and written English
• Previous customer service experience
• General computer skills and experience

Schedule:

• 80hrs/2wks
• Monday-Friday - 8:30am-5:00pm

Northfield Hospital + Clinics has a 100+ year history of providing exceptional care for our patients. Here, our employees drive our success and our reputation. We value great employees, and offer competitive salaries and a variety of benefits (when hired for 40 hours/pay period or more.) It's our commitment to maintaining an excellent workforce.

In this position, we offer:

• Competitive Wages Based on Experience, $18.10-$25.55 per hour (experience and education may be considered along with internal equity when job offers are extended)
• Eligible for Medical and Dental Insurance, Vision Discount Plan
• Life and Disability Insurance
• Pension Plan (PERA) with a 7.5% company match
• 457(b) Retirement Plans
• Tuition Reimbursement
• Free On-site Parking
• Other benefits include our Qualified Bilingual Staff Program, Employee Assistance Program, and a variety of savings opportunities, including cafeteria, pharmacy, and scrubs discount.

Northfield Hospital + Clinics is an independent organization with over 800 employees. We are known for our positive work environment and quality patient care. We provide a full spectrum of services with our Hospital in Northfield, MN and primary and specialty clinics in Northfield, Lakeville, Farmington, Faribault, and Kenyon. Urgent Care locations in Northfield and Lakeville.