Job Description
Caring For the Community You Love Choose a career to make a difference in people's lives every day, choose Fisher-Titus! Perks of working at Fisher-Titus: • Hours of Work- Full time • Comprehensive Benefits Package- Medical & Dental coverage, 401K match, paid time off, tuition assistance and more! • Shift, Weekend & PRN differential About Fisher-Titus: Fisher-Titus proudly serves the greater Huron County area’s 70,000-plus residents by providing a full continuum of health and wellness care from heart and cancer care to outpatient services such as lab, imaging, and physical rehabilitation.
Vision: Be the first choice for healthcare and employment within our community Mission: Deliver compassionate and convenient care to the highest level of excellence that promotes lifelong health and wellness for our community General Summary:
The Prior Authorization Specialist I is responsible for ensuring that payers are prepared to reimburse Fisher-Titus for services in accordance with the payer-provided contract. The Specialist contacts payers to request service authorization and may collect financial and/or demographic information from patients as needed.
Essential Functions: • Verifies patients’ insurance and benefits information • Obtains prior authorization from third-party payers in accordance with payer requirements • Will contacts patients to gather demographic and insurance information as needed, and updates patient information within the EMR as necessary • Works with other departments to gather the clinical information required by the payer to authorize services • Maintains accurate records of authorizations within the EMR • Identifies patients who will need to receive Medicare Advance Beneficiary Notices of Noncoverage (ABNs) • Refers accounts to financial counseling as needed if authorization is not obtained • Works directly with and supports the needs of the Denial/Appeals committee.
• Complies with HIPAA regulations, as well as the organization's policies and procedures regarding patient privacy and confidentiality • Continually maintains professional tone when communicating with patients and payer representatives • Performs other clerical duties as requested Education Required • Associates or better in Business Administration Equal Opportunity Employer
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