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Prior Authorization Specialist

Indiana Heart Physicians

 

Address   Franciscan Physician Network
    5330 East Stop 11 Road
    Indianapolis, IN 46237

Hours  Days

Calendar  Full-Time; 40.00/week

Education High School Diploma/ GED Required

Medical Assistant or LPN Required

WHAT WE NEED

Persistent & pleasant authorization experts

WHO WE ARE LOOKING FOR

Health insurance, authorization, and documentation are not for the faint of heart. It can be a confusing field with as many different situations as there are patients. If you’re good at figuring out the details, chasing down the right people, and coordinating documents – we have a position that needs your skills. This is a position with a mission: helping patients get the medical services they need.

Do you have a way with details? Do you have knowledge of insurance requirements? Do you love figuring out how to best resolve a problem? We’d love to put your positivity to work.

WHAT YOU WILL DO

  • Serve as primary contact for all ambulatory department prior authorization requirements.
  • Serve as primary resource to ambulatory clinics reading the prior authorization process and requirements.
  • Collect clinical information regarding services to be rendered.
  • Contact payer to obtain prior authorization. Gather additional clinical and or coding information, as necessary, in order to obtain prior authorization.
  • Provide standardized documentation within EPIC to identify prior authorization and the criteria surrounding such authorization.
  • Advise providers and their clinical staff when issues arise relating to obtaining prior authorization. 
  • Stay informed and research information regarding insurance criteria for prior authorization.
  • Serve as primary resource to patients regarding prior authorization process. 
  • Verify that all insurance requirements have been met.
  • Educate providers and their clinical staff regarding the prior authorization process.

WHAT IT TAKES TO SUCCEED

  • Understanding of insurance requirements for prior authorization.
  • Knowledge of registration, verification, pre-certification, and scheduling procedures.
  • Understanding of payer processes (website, fax, contact number) to submit appropriate clinical documentation.
  • Basic knowledge of Microsoft Office and Outlook.
  • Basic knowledge of Medical Terminology and Medical Coding.
  • Understanding of insurance billing procedures and practices.
  • Familiar with Electronic Health Systems/Electronic records.


WHAT WE'RE LOOKING FOR

 

1-3 Years Experience

License(s): Not Applicable

Certification(s): Not Applicable

Travel: Never or Rarely

 

EQUAL OPPORTUNITY EMPLOYER

It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law.

Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights.

Franciscan Alliance is committed to equal employment opportunity.


Nearest Major Market: Indianapolis

Job Segment: Medical, EMR, Medical Coding, Medical Assistant, Nursing, Healthcare