What are the responsibilities and job description for the Authorization Specialist - CNA position at Regional West Health Services?
About the Role:
The Authorization CNA Specialist will obtain prior authorizations for surgeries and all modalities including diagnostic imaging, cardiac imaging, procedures, prescription medications, Veterans Administration authorizations, some durable medical equipment, and outside referral authorizations. This position ensures that prior authorizations are completed promptly and accurately. This position is responsible to properly document in the electronic health record per the Prior Authorization protocol.
Qualifications:
- High school diploma or equivalent required; completion of a Certified Nursing Assistant (CNA) program is mandatory.
- Valid CNA certification and current registration in the state of employment.
- Minimum of 2 year experience in a healthcare setting, preferably involving patient care coordination or administrative support.
- Strong knowledge of healthcare insurance processes, including prior authorization requirements.
- Proficiency in using electronic health records (EHR) systems and standard office software.
- Experience working in a hospital or clinical environment with direct exposure to insurance authorization processes.
- Familiarity with medical terminology and clinical procedures relevant to authorization requests.
- Demonstrated ability to handle multiple tasks efficiently in a fast-paced environment.
- Excellent interpersonal skills with experience in patient advocacy or customer service.
Responsibilities:
- Review and process authorization requests for clinical services, ensuring accuracy and completeness of documentation.
- Communicate with healthcare providers, insurance companies, and patients to obtain necessary approvals and resolve any issues related to coverage.
- Maintain detailed records of authorization requests, approvals, denials, and appeals in compliance with organizational and regulatory standards.
- Monitor authorization status and follow up on pending requests to prevent delays in patient care.
- Collaborate with clinical and administrative teams to support patient care coordination and resolve authorization-related challenges.
A conditional job offer is contingent upon successfully passing a pre-employment drug test and background checks. A Physical Capacity Profile may be required for some positions.