Admissions and Authorization Specialist

Job Title: Admissions & Authorization Specialist

We're seeking a detail-oriented and efficient Admissions & Authorization Specialist to join our Patient Access team. In this role, you'll play a crucial part in facilitating financial reimbursement and minimizing the organization’s financial risk. Your work will directly support our mission by helping us operate efficiently and sustainably.

About Speare Memorial Hospital

Speare Memorial Hospital is a 25-bed critical access hospital serving dozens of communities in the Lakes Region. We are passionately committed to providing exceptional, local care to our friends, families, neighbors, and communities at large.

Mission: To work together to serve the needs of our patients and community.

Vision: A community where all can achieve optimal health.

Values: Kindness, Collaboration, Patient & Family-Centered, Safety, Excellence, Efficiency, and Professionalism.

What You’ll Do:

Authorization & NOA Responsibilities:

• Review scheduled services to determine authorization requirements based on payer guidelines
• Submit timely Notice of Admission (NOA) to CMS and private payers within the required 24-48 hour regulatory window to avoid reimbursement penalties
• Initiate and complete prior authorizations via payer portals, phone, or fax
• Obtain and verify required clinical documentation to support medical necessity for both authorization forms and NOA submissions
• Track and follow up on authorization and NOA status to prevent delays, denials, or “untimely filing” reductions
• Communicate authorization outcomes and NOA-related issues to clinical and billing departments

Patient Access/Registrar Backup Responsibilities:

• Greet and direct patients and visitors appropriately
• Register patients for hospital services
• Verify demographic and insurance information
• Perform real-time insurance eligibility verification
• Obtain required patient signatures and provide “Important Message from Medicare” (IM) or “Notice of Medicare Non-Coverage” (NOMNC) where applicable

General Responsibilities

• Maintain patient confidentiality and HIPAA compliance
• Participate in training and continuing education
• Support revenue cycle process improvements
• Demonstrate strong customer service and professionalism

What We’re Looking For:

Required:

• High School Diploma
• 1-2 years healthcare experience required
• Knowledge of insurance authorization workflows
• Attention to detail and accuracy
• Strong communication and organizational skills
• Ability to multitask in a fast-paced environment
• Proficiency in EMR systems and payer portals
• Ability to work independently and escalate appropriately

Preferred:

• Associate’s Degree
• Prior authorization Notice of Admission filing, and Meditech experience highly preferred

Why Join Speare Memorial Hospital?

• Community Connection: Be part of an organization deeply invested in local health and wellness.
• Collaborative Culture: Work alongside dedicated professionals who genuinely care about their work and each other.
• Professional Growth: Opportunities for continuing education and career development.
• Comprehensive Benefits:
  • Competitive salary
  • Health, dental and vision insurance
  • Health savings accounts with employer contributions
  • 403(b) retirement plans with generous employer contributions
  • Lifestyle Savings Account reimbursement program
  • Tuition Assistance and Student Loan Repayment programs
  • Employee recognition and appreciation programs
  • Generous Earned Time accrual
  • Short-Term & Long-Term Disability
  • Life insurance

Our Commitment

Speare Memorial Hospital is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We believe that a diverse workforce strengthens our ability to serve our equally diverse community.

Join us in our mission to provide compassionate, high-quality healthcare to our community.