Outpatient Administrative Rep - Funding Services

Administrative Representative

Location: Hybrid, in office once a week/remote after 6 months.

Salary Range: $18.65 - $26.86/h, depending on experience.

POSITION SUMMARY: The Administrative Representative position is responsible for insurance authorization and verification, ensures all insurance-related information is accurately documented. This position will be responsible for tracking authorizations for medical procedures, medications, or specialized treatments/therapies. Follow-ups on pending or denied authorizations, works with clinical/therapy teams to submit required medical documentation. Keeps detailed insurance benefits-related data in EPIC/electronic health records system.

POSITION REQUIREMENTS:

• Licensure/Certification/Registrations: None
• Education: A high school diploma or equivalency is required.
• Experience: 1-3 years front desk experience in a clinical environment required. Previous experience with medical terminology, charge entry and EPIC software, Medicare/Medicaid and commercial insurance preferred.
• Skills & Abilities: Excellent skills in team-building, conflict resolution, and communication skills; both verbal and written. Able to organize and prioritize multiple tasks effectively. Ability to demonstrate professionalism while dealing with the stressors of operating a multi-line telephone system. Ability to work with frequent interruptions and complete assignments in a timely manner. Work collaboratively within the department, other departments and physicians. Strong computer skills with Microsoft applications preferred. Spanish speaking preferred.

ESSENTIAL FUNCTIONS:

• Verify Eligibility: Check insurance portals and call insurance companies to confirm patient enrollment, active benefits, and responsibilities of cost.
• Secure Authorizations: Submit and track prior authorization requests for medical procedures, medications, or specialized treatments/therapies.
• Resolve Issues: Follow up on pending or denied authorizations, working with clinical/therapy teams to submit required medical documentation.
• Data Entry: Document detailed insurance benefits, approval numbers, and expiration dates accurately within the electronic health record (EHR) system and tracking program.

** This job description is not intended to be an exhaustive list of all duties. Employee may perform other related duties as assigned.

Craig Hospital Benefits:

At Craig Hospital we offer a wide range of outstanding benefits that allow our employees to tailor a benefits package that meets their individual needs. Planning a family or looking forward to retirement we have options. Our medical insurance is a self-funded plan administered by Allegiance Benefit Plans with a CIGNA network of providers offering two different comprehensive plans. We offer dental insurance through Delta Dental, and vision insurance through EyeMed. Craig offers Health Care and Dependent Care Spending Accounts. Craig also provides, and pays for both Short Term and Long Term Disability Insurance plans for every benefit-eligible employee. We offer generous time-off benefits to allow you to enjoy your time away from work too! Additionally, we have a 403b Retirement Plan with a generous matching contribution through Empower Retirement that you are eligible for upon hire. Want to go back to school? We have Tuition Assistance. Unexpected emergency? We have Employee Assistance Programs and an Employee Emergency Assistance Fund.

At Craig we believe in offering best-in-class benefits and prioritize benefits to support you.