Clinical Insurance Authorization Specialist Spencer Hospital Job at Avera, Spencer, WI

RUp1cVFlUVVLOUhtRDZQWm1qVGM5aUJjZFE9PQ==
  • Avera
  • Spencer, WI

Job Description

Location:

Spencer IA

Worker Type:

Regular

Work Shift:

Day Shift (United States of America)

Spencer Hospital is proud to employ highly skilled and caring staff members. We offer competitive salaries and benefits as well as a pleasant work environment.

Position Highlights

Spencer Hospital is a rural hospitallocated in northwest Iowa employing over 500 employees. Positions at Spencer Hospital are not affiliated with Avera; however we collaborate to provide services to the communities we serve. Employment offers if accepted are exclusively with Spencer Hospital.

Responsibilities:

  • Coordinate with staff in order to complete prior authorization for all services and procedures in an accurate and timely manner.
  • Ensure that all supporting documentation is available and shared with payers to expedite authorizations.
  • Maintaining authorizations which includes gathering necessary documents to support authorization requests submitting initial requests for authorization following up on authorization requests and communicating with departments and providers on status of authorizations.
  • Coordinate with providers as needed to ensure treatments/services meet medical necessity criteria. Assist with appeals for claim denials due to the authorization process.
  • Develop and implement prior authorization workflow policies and procedures. Collaborate with other departments to assist in obtaining pre-authorizations in a cross functional manner.
  • Share information with providers and staff regarding coverage criteria medically necessary criteria.

Requirements:

  • Current active Licensed Practical Nurse (LPN) license in Iowa or an active multistate license through the Nurse Licensure Compact (NLC). Must be eligible to practice in Iowa.
  • Prior hospital and/or clinical authorization experience preferred.
  • Must uphold high ethical standards.
  • Exhibit poise and tact when working with staff physicians and other members of the healthcare team.
  • Excellent oral communication skills and the ability to interact with customers in a professional manner are essential.
  • Must be adaptable and flexible in moving between various functions based on workload demand.
  • Must have excellent organizational skills.

Schedule:

  • 72 or 80 hours per pay period
  • Mon-Fri; 8a-4:30pm
  • The schedule may fluctuate based upon the needs of the hospital

Spencer Hospital offers competitive wages affordable insurance IPERS retirement in-house education paid time off family gym membership and so much more!

Please contact Spencer Hospital Human Resources for any questions at 712.264.6205 or email .

Learn more about Spencer Hospital:

Required Experience:

IC

Job Tags

Full time, Flexible hours, Shift work, Day shift

Similar Jobs

The Mill School

Substitute Teacher @ Early Education / Child Care Center Job at The Mill School

 ...Summary We are seeking substitute teachers at our child care center in Woodstock, Vermont (The Mill School)! This position will be on...  ...Child and Family Services and at least twelve (12) months experience working with groups of children from grade three (3) or younger... 

Rooms To Go

Ecommerce Merchandising Associate Job at Rooms To Go

 ...:The Ecommerce Merchandising Associate is an expansion role within the Rooms To Go family! The individual will be responsible for but not limited to working with our vendors on product selection, website curation, product evaluation, and performance on web. This is a... 

Nexon America Inc

Associate Producer Job at Nexon America Inc

Description: for Pay Transparency (annually) The base salary range for this position in El Segundo, CA is $70,000 - $83,000 annually. Our salary ranges are determined by market data based on position and level. The range displayed on each job posting reflects the minimum...

Devereux Advanced Behavioral Health

Human Services Paid Summer Intern Job at Devereux Advanced Behavioral Health

 ...spectrum disorders preferred . Must be able to attend a 2-week paid orientation Monday to Friday 8AM to 4PM in Rutland MA....  ...Devereux is a great place to work! Devereux is a drug-free workplace drug screening required. EOE Required Experience: Intern... 

The Forehand Agency

Remote Insurance Sales Representative — Accelerated Leadership Path Job at The Forehand Agency

 ...The Forehand Agency seeks a Remote Insurance Sales Representative to support account growth and deliver excellent customer experiences while progressing through an accelerated leadership path. This fully remote role blends consultative sales, customer service, and operational...