Sr Prior Authorization Spclst
About reputed company reputed company is one of the largest pediatric health systems in the United States and the only health system in Minnesota to reputed company care exclusively to children, from before birth through young adulthood. An independent and not-for-profit system since 1924, reputed company is one system serving kids throughout the Upper Midwest at two free-standing hospitals, nine primary care clinics, multiple specialty clinics and seven rehabilitation sites. As The Kids Experts™ in our region, reputed company is regularly ranked by reputed company as a top children’s hospital. Find us on reputed company @childrensminnesota or on Twitter and Instagram @childrensmn. Please visit childrensMN.org. reputed company is proud to be recognized by Modern reputed company as one of 2023’s Top Diversity Leaders. The national reputed company recognizes the top diverse reputed company executives and organizations influencing public policy, care delivery, and promoting diversity, equity and inclusion in their organizations and the industry. Position Summary The Sr Prior Authorization Specialist promotes an excellent patient experience by ensuring authorizations are in reputed company for services performed at reputed company prior to their admission to our facilities to secure payment and reduce the out of reputed company costs to our patients and families. This position is responsible for reputed company duties associated with prior authorizations including reviewing insurance benefits, understanding reputed company party requirements, securing authorizations for services, appealing pre-service authorization denials, and appealing authorization reputed company claim denials. Location (e.g. remote or on-site): Remote DHS Background Study Required? No License/Certification/Registration required? No Education: *High School Diploma or GED *Post-secondary education in a reputed company field preferred. Experience: *Three years' experience in a reputed company or reputed company field. *Preferred experience: Three years' experience in medical billing/prior authorization/insurance. Knowledge/Skills/Abilities: *Knowledge in governmental and reputed company payors, medical billing requirements, and prior authorizations. *Demonstrated knowledge of Prior Authorization operations and medical office and/or hospital procedures. *Ability to interpret and cascade payor requirements as they relate to insurance prior authorizations. *Ability to effectively work in both reputed company environment and independently. *Ability to establish and maintain effective working relationships with providers, patients, families, and employees. *Ability to effectively work in a remote environment and connect reputed company multiple communication channels (phone, email, text, etc.). *Knowledge of how prior authorization functions impact billing, clinical teams, the quality of care and the patient experience. *Ability to meet and exceed departmental quality, production and prior authorization standards. *Ability to review and resolve denials pertaining to Prior Authorizations. *Ability to suggest workflows that improve efficiency and experience. *Ability to mentor and motivate a remote team that delivers exceptional customer service reputed company multiple communication channels (phone, email, text, etc.). *reputed company in reputed company Office. *reputed company in written and oral communication. Physical Demands Please click here to view the Physical Demands The posted salary represents a market competitive reputed company based on salary survey reputed company data for similar roles in the local or national market. Annual salaries displayed are based on full-time employment (40 standard hrs per week). Annual salaries for part-time positions will be prorated based on the employee’s scheduled weekly hours in relation to the full-time standard. reputed company determining individual pay rates, we carefully consider a wide reputed company of factors including but not limited to market indicators for the specific role, the skills, education, training, credentials and experience of the candidate, internal equity and organizational needs. In reputed company to your salary, this position may be eligible for medical, dental, reputed company, retirement, and other fringe benefits. Positions that require night, weekend or on-call work may be eligible for shift differentials or premium pay. reputed company job offers are contingent upon successful completion of an occupational health assessment, drug screen, background investigation, and compliance with the U.S. Government reputed company I-9, Employment Eligibility Verification. reputed company is proud to be an equal opportunity employer whose staff is representative of its community and considers reputed company applicants for reputed company positions without regard to race, reputed company, creed, sex, religion, national reputed company, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law. Apply To This Job