Job Description
Overview The Insurance Pre-Authorization Specialist is responsible for processing submissions for insurance prior authorizations (PA) and coordinating any denials follow up, as indicated.
Responsibilities Analyzes information required to complete pre- authorizations with insurance carriers and governmental payors.
Obtains necessary information to accurately process pre-authorization requests.
Utilizes third party payer/insurance portals to process PA submissions; has a detailed knowledge of insurance providers, their portals and their expectations for authorization approval.
Advocates for patients/providers by processing PA's in a time sensitive manner and collaborating, as indicated with physicians and nurses, to accurately secure clinical information to support the PA submission.
Cross-trains to support additional office/scheduling functions as deemed necessary for optimal business operations.
Coordinates any denial follow-up, as indicated
Process FMLA/Disability Paperwork
Qualifications Certifications: , Education: , Work Experience: Health insurance
Carle Health Company Overview Find it here. Discover the job, the career, the purpose you were meant for. At Carle Health, we're committed to fostering a workplace where every team member feels valued, respected and empowered, where passion and purpose come together to positively impact the lives of our patients and our communities. Find it all at Carle Health.
Our nearly 17,000 team members and providers work together to support patient care across central and southeastern Illinois. We've grown to include eight, award-winning hospitals and a multispecialty provider group with more than 1,500 doctors and advanced practice providers. We're developing the next generation of providers and healthcare professionals through Carle Illinois College of Medicine, the world's first engineering-based medical school, and Methodist College. Carle BroMenn Medical Center, Carle Foundation Hospital, Carle Health Methodist Hospital, Carle Health Proctor Hospital, Carle Health Pekin Hospital, and Carle Hoopeston Regional Health Center hold Magnet® designations, the nation's highest honor for nursing care. We offer opportunities in several communities throughout central Illinois with potential for growth and life-long careers at Carle Health.
We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. Carle Health participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization. | For more information: human.resources@carle.com.
Salary Range The compensation range for this position is $19.22per hour - $31.14per hour. This represents a good faith minimum and maximum range for the role at the time of posting by Carle Health. The actual compensation offered a candidate will be dependent on a variety of factors including, but not limited to, the candidate's experience, qualifications, location, training, licenses, shifts worked and compensation model.
Carle Health offers a comprehensive benefits package for team members and providers. To learn more visit careers.carlehealth.org/benefits.
Job Tags
Work experience placement, Work at office, Local area, Shift work