Please take note that this role will require someone to have working knowledge of how to handle denial of claims including writing and assembling all the documents to handle an appeal if and when the prior auth is denied.
Job Summary
Beacon Hill's client is looking for a Prior Authorization Specialist who will serve as a central contact for patients, providers and payers, via telephone (and potentially in person), assisting them in obtaining insurance pre-authorization for procedure. This individual will provide exceptional customer service to meet the needs of patients and other healthcare providers.
This position is onsite in Plymouth, MN and a direct-hire position.
Key Responsibilities
Operates computer and phone system to appropriately and accurately record contacts, discussions, patient tracking and the pre-authorization process.
Verifies and updates patients' insurance and demographic information.
Researching and recording payer processes for pre-authorizations and appeals
Verifies and updates insurance cards/ eligibility, other billing-related documents and
completes work activities to ensure work assigned is completed in a timely manner.
Follows regulatory and organizational processes to ensure the necessary forms are completed
Operates a fax machine, photocopier and/or printer effectively to communicate patient
Information to the necessary recipients.
Identifies and resolves problems in a professional and timely manner by collecting and
relaying information to appropriate team to ensure resolution.
Pleasant demeaner with patients and their providers
Regular in-office attendance is required to carry out the essential functions of the position.
Reviews and meets ongoing competency requirements of the role to maintain the skills,
knowledge, and abilities to perform, within scope, role specific functions.
Qualifications and Skills
High School Diploma or GED.
1 year of physician billing
Patient insurance verification or pre-authorization experience in a health care setting, required; 2 years preferred
Knowledge of various insurance plans (HMO, PPO, POS, Medicare, Medicaid) and payors required
Basic understanding of medical terminology
HIPAA regulations and Microsoft Office programs
Must have the knowledge on how to handle a denial, including writing up and assembling all the paperwork required for this.
Beacon Hill is an Equal Opportunity Employer that values the strength diversity brings to the workplace. Individuals with Disabilities and Protected Veterans are encouraged to apply.
California residents: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.
If you would like to complete our voluntary self-identification form, please click here or copy and paste the following link into an open window in your browser: https://jobs.beaconhillstaffing.com/eeoc/
Completion of this form is voluntary and will not affect your opportunity for employment, or the terms or conditions of your employment. This form will be used for reporting purposes only and will be kept separate from all other records.
Company Profile:
Founded by industry leaders to set a new standard in search, career placement and flexible staffing, we deliver coordinated staffing solutions with unparalleled service, a commitment to project completion and success and a passion for innovation, creativity and continuous improvement.
Our niche brands offer a complete suite of staffing services to emerging growth companies and the Fortune 500 across market sectors, career specialties/disciplines and industries. Over time, office locations, specialty practice areas and service offerings will be added to address ever changing constituent needs.
Learn more about Beacon Hill and our specialty divisions, Beacon Hill Associates, Beacon Hill Financial, Beacon Hill HR, Beacon Hill Legal, Beacon Hill Life Sciences and Beacon Hill Technologies by visiting www.bhsg.com .
