We are seeking a dedicated and capable Prior Authorization Administrative Assistant to support the pre-certification and billing processes for our authorization department including patient procedures, testing, trauma and interventional neuroradiology. 

The primary responsibilities of this role are ensuring proper documentation is submitted for procedures, updating patient registration information, ensuring prior authorization is completed for all procedures requiring authorization and ensuring billing is complete for all procedures. Additionally, the role will provide support to the Prior Authorization Manager including tasks, projects, phone coverage and mail processing for the prior authorization team. In order to ensure efficiency and accuracy, the role will require comfort with reporting and data analysis. This position plays a key role in facilitating effective information intake for billing and collections purposes. Once fully trained, this position offers the opportunity to have a hybrid remote schedule. 

Outstanding employees in this role are highly organized, detailed, conscientious and efficient while striving to deliver the highest level of service. The role requires an individual that is driven to process improvement through organization and critical thinking. As this role is an essential part of our team, active communication and respectful collaboration with peers is vital to success. The abilities to multi-task and be flexible are vital to succeed in this role.

1. Prior Authorization Phone Triage
   1. Distribute to appropriate departments (prior authorization, test scheduling, billing, nurses, etc.)
   2. Answer appropriate questions:
      • Non-medical judgment issues
      • Information read from the patients chart/transcription
      • Per standard orders of provider based on written protocols
2. Responsible for ensuring all trauma and interventional neuroradiology encounters are processed in an efficient and accurate method
   1. Collect surgical, rounding & call charges from providers.
   2. Patient Registration
      1. Completing unfinished patient registrations.
      2. Scan Insurance Card if applicable.
      3. Obtain any missing information in the chart or registration process.
   3. Ensure all diagnosis, procedure codes, and operative notes are included.
   4. Send paperwork to the medical coder.
3. Process and File Prior Authorization Mail
4. Reporting
5. Assist other areas when needed
6. Other duties as assigned

• Knowledge of medical insurance plans
• Exceptional attention to detail with drive to create process
• Ability to work independently
• Ability to collaborate and communicate clearly
• Ability to respectfully interact with physicians, providers, peers and patients
• Outstanding computer and internet skills
• Alignment with HIPAA regulations
• Respect for organizational policies, procedures, systems and objectives

Education: High school diploma or equivalent

Preferred Experience: 1-3 years hospital or medical office experience, 2 years of medical billing experience preferred.

Physical Demands

Able to sit for an extended period of time in focused work.

Long periods of telephone and computer work.