WMH Prior Authorization Representative - Full-time

Description

Full-Time. (Days / Evenings)

Responsible for obtaining prior authorization from payers for inpatient and outpatient services provided by Wayne Memorial Hospital. This role is key to assuring proper coding of procedures, obtaining authorizations for payment and assisting with collection of reimbursement while minimizing insurance denials and bad debt balances.

Minimum Requirements

High School graduate or equivalent required. Associate degree in Business, Finance, Health Information Management or a related field preferred.

Requires one year of experience in healthcare, business, finance, or insurance related field. Knowledge of and / or experience in CPT and ICD coding and Medicare and third-party payer regulations and guidelines preferred.

Requires the ability to communicate effectively, cooperatively and discreetly

Excellent customer service skills

Basic computer / keyboard skills

Medical terminology preferred

Word processing experience preferred. (WORD / EXCEL)