Prior Authorization Representative

Coffeyville Regional Medical Center, or "CRMC", is a 25-bed, non-profit, critical access hospital serving Southeast Kansas and Northeast Oklahoma since 1949. As a rural hospital, CRMC is surprising because of its large size and wide variety of services. Although we can provide many of the same services you will find in a big city, we take great pride in our friendly and caring staff. Prior Authorization Clerk The Prior Authorization Clerk performs all tasks necessary for processing insurance pre authorizations while providing the highest level of service. JOB DUTIES Collect all necessary documentation to perform proper authorizations Verify prior authorization and/or pre-service requirements are met Manage and maintain all outstanding authorizations accounts to increase billing of clean claims Research patient accounts due to invalid and/or missing authorization information to resolve denials Document eligibility, benefit and authorization information in accordance with established guidelines Contact the patient or provider, as needed, for additional information and completion of required documentation to obtain prior authorization Interact with providers, patients, insurance companies and others as necessary to request prior authorizations Document account activity; update patient and claim information; and demonstrate proficiencies within the billing system for efficient processing of claims Maintain confidentiality of all information according to HIPAA and company policy The Prior Authorization Clerk assumes other responsibilities as assigned. JOB REQUIREMENTS Analytical ability to apply criteria and evaluate information to make decisions Strong verbal and written communication skills; and excellent interpersonal skills in teaming with patients, medical staff and the public Detail oriented with proven ability to multitask Computer skills including MSOffice, Outlook, Meditech, preferred EDUCATION AND EXPERIENCE H.S. Diploma, G.E.D. or equivalent work experience in field, required Medical billing certification, preferred 1-2 years’ experience in medical billing or insurance claims, preferred CRMC BENEFITS OVERVIEW Our comprehensive compensation plan includes the following benefits. Generous paid time off Medical/Dental/Vision Kansas Public Employees Retirement System (KPERS) 403B Retirement Savings Additional Voluntary Insurance Federal Student Loan Public Service Loan Forgiveness Eligible Employer Voluntary Short Term Disability Employee Assistant Program Free Indoor Walking Track & Gym Coffeyville Regional Medical Center is an Equal Opportunity Employer. We are committed to creating a diverse environment. We believe that diversity and inclusion among our associates is critical to our success. All qualified applicants will receive consideration of employment without regard to race, color, religion, gender, gender identify, sexual orientation, national origin, genetics, disability, age, or veteran status. If you need assistance or a reasonable accommodation, please contact Human Resources at View email address on click.appcast.io or View phone number on click.appcast.io. #J-18808-Ljbffr