Position Description:

• Locates, reviews and obtains appropriate chart documentation from all sources (Physician, CERNER, etc.) based on payer requirements needed to obtain prior authorization for scheduled/ add-on IP and OP procedures/admissions/surgeries.
• Communicates with physician office regarding status of authorization, information needed, facilitates, and completes peer-to-peer reviews when needed.
• Initiate appeals for denied authorizations prior to service rendered avoiding denials and or penalties to the facility.
• Understands Insurance processing requirements i.e.; (verification, authorization, terms, requirements and regulations) and familiar with payer processes to obtain authorization in a timely manner.

• Challenging and rewarding work environment
• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match and discounted stock plan
• SoFi Student Loan Refinancing Program
• Career development opportunities within UHS and its 300 Subsidiaries!
• Retention Bonus Program if offered.
• Loan Forgiveness Program if offered.

Requirements:

• Associate degree in business or related major preferred and or 5 years or more of directly related experience performing same or similar job function. CHAA - (Certified Healthcare Access Associate) certification preferred.
• Five (5) years' experience in a health care facility or equivalent position performing same or similar job duties required.
• Medical Terminology completion preferred, understanding of third-party payer requirements (Authorization, verification and regulations).
• Ability to receive and express detailed information through oral and written communication.