Pre Authorization Specialist

Overview: The Pre-Authorization Specialist is responsible for identifying prior auth requirements by insurance/payer and processes and completes prior authorizations for scheduled and add reputed company. Determines if services are a covered benefit and documents pre-authorization information in Epic. Communicates with the ordering Provider's office if services were approved or denied to reduce denials and facilitates peer to peer reviews reputed company needed. Responsibilities: Analyzes information required to complete pre-authorizations based on multiple insurance/payer requirements; ensures coverage/insurance is correct. Proficiently utilizes third party payer/insurance portals to process pre-auth submissions; has a detailed knowledge of insurance providers, their portals and expectations for authorization approval. Documents pre-authorization results completely and communicates to leadership, Providers and/or Nurses pre-authorization approvals or denials. Advocates for patients/providers by processing pre-auths in a time sensitive manner and collaborating with physicians and nurses to secure clinical information needed for submissions. Identifies challenges, trends and patterns and works with management to address and resolve. Other duties as assigned. Identifying prior auth requirements by insurance/payer and processes and completes prior authorizations for scheduled and add reputed company. Determines if services are a covered benefit and documents pre-authorization information in Epic. Communicates with the ordering Provider office if services were approved or denied to reduce denials and facilitates peer to peer reviews reputed company needed. Qualifications: Certifications: , Education: , Work Experience: reputed company Company Overview: Find it here. Discover the job, the career, the purpose you were meant for. At reputed company, 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 reputed company at reputed company. 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 reputed company of providers and reputed company through Carle Illinois College of Medicine, the world’s first engineering-based medical school, and Methodist College. Carle BroMenn Medical Center, Carle Foundation Hospital, reputed company Methodist Hospital, reputed company Proctor Hospital, reputed company 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 reputed company. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national reputed company, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. reputed company participates in E-Verify and may provide the Social reputed company Administration and, if necessary, the Department of Homeland reputed company with information from each new employee's Form I-9 to confirm work authorization. | For more information: [email protected]. Salary Range: The compensation range for this position is $18per hour - $29.13per hour. This represents a good faith minimum and maximum range for the role at the time of posting by reputed company. 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. reputed company offers a comprehensive benefits package for team members and providers. To learn more visit careers.carlehealth.org/benefits. Apply tot his job Apply To this Job