Prior Authorization Specialist

1.0 FTE (40 hrs/wk); Monday – Friday, business hours. This position requires initial on-site training at the 455 location in St. Paul, and then will transition to a remote working role. However, the selected candidate must reside in Minnesota or Wisconsin and have the ability to work onsite in St. Paul, MN as needed.

This position exists to facilitate the processing of authorizations, certifications and referrals needed by payers in order to allow reimbursement at the highest levels for both the patients and for the organization. Utilize available resources to check patient insurance benefits and eligibility to better inform our patients of their estimated financial liability.

Compensation & Benefits:

The hourly wage for this opportunity is $21.88/hour to $30.87/hour, with a median wage of $25.72/hour. Pay is dependent on several factors including relevant work experience, education, certification & licensure, and internal equity. Hourly pay is just one part of the compensation package for employees. Gillette supports career progression and offers a competitive benefits package that includes a retirement savings match, tuition and certification reimbursement, paid time off, and health and wellness benefits for 0.5 FTE and above. 

Qualifications:

Required:

• High School Diploma/ GED
• 1 year experience in customer service, administrative, or healthcare setting

Preferred:

• Advanced education (Associate or Bachelor’s) 

Knowledge, Skills and Abilities:

• Knowledge & understanding of medical terminology
• Knowledge & understanding of commercial insurance carriers and standard insurance forms
• Demonstrated strength in customer service, organization, attention to detail and the ability to work independently
• Demonstrated strong teamwork skills
• Demonstrated ability to multi-task and respond quickly/reprioritize changing needs
• Strong computer aptitude including knowledge of Microsoft Office (Word, Excel, Outlook)

At Gillette Children’s, we foster a culture where every team member feels a sense of belonging and purpose. We are dedicated to building an environment where all feel welcomed, respected, and supported. Our values are embedded at the heart of our culture. We act first from love, embrace the bigger picture, and work side-by-side with our patients, families, and colleagues to help every child create their own story. Together, we work to ensure patients of all backgrounds and abilities reach their full potential.

Gillette Children's is an equal opportunity employer and will not discriminate against any employee or applicant for employment because of an individual's race, color, creed, sex, religion, national origin, age, disability, marital status, familial status, genetic information, status with regard to public assistance, sexual orientation or gender identity, military status or any other class protected by federal, state or local laws.

Gillette Children’s is a global beacon of care for patients with brain, bone and movement conditions that start in childhood. Our research, treatment and supportive technologies enable every child to lead a full life defined by their dreams, not their diagnoses.

To learn more about working at Gillette Children's, please visit https://www.gillettechildrens.org/careers.

Gillette Children's participates in the U.S. Department of Homeland Security (DHS) E-Verify program which is an internet-based employment eligibility verification system operated by the U.S. Citizenship and Immigration Services. If E-Verify cannot confirm that you are authorized to work, Gillette will give you written instructions and an opportunity to contact DHS or the Social Security Administration (SSA) to resolve the issue before Gillette takes any further action. Please visit https://www.e-verify.gov/ for further details regarding e-verify.

Salary : $22 - $31