Prior Auth Representative Associate at Spectrumhealth
Epic experience
Payor portal experience
About Corewell Health
How Corewell Health cares for you
Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here .
On-demand pay program powered by Payactiv
Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!
Optional identity theft protection, home and auto insurance
Traditional and Roth retirement options with service contribution and match savings
Eligibility for benefits is determined by employment type and status
Primary Location
SITE - Care Center Breton - 4600 Breton Rd SE - Kentwood
Department Name
Contact Center Pre Authorizations - Corporate
Employment Type
Full time
Shift
Day (United States of America)
Weekly Scheduled Hours
40
Hours of Work
8:30 a.m. to 5 p.m.
Days Worked
Monday to Friday
Weekend Frequency
N/A
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You may request assistance in completing the application process by calling 616.486.7447.
Benefits
Health insuranceVision insuranceRemote work optionsEquity / stock options
Additional Information
Job Summary
Provides clerical support to assist in the delivery of quality healthcare services via a Financial Clearance model by way of obtaining accurate and timely authorizations. Crucial to obtaining an authorization is the ability to read and understand basic insurance information as well as perform a complete and accurate registration. Training will consist of six weeks of in-person instruction and will shift to remote training after that time pursuant on satisfactory progress including authorizations obtained daily and a passing audit score.
Essential Functions
Demonstrates the ability to utilize all payer websites and maintains up to date credentials to assist verifying patient's coordination of benefits and authorization requirements.
Able to perform chart abstraction to pull clinical data from a patient's chart for review by a payer's clinical team.,
Adheres to all department procedures, guidelines, and standard work with the ability to utilize resources appropriately.
Complete authorization requests in a timely and efficient manor without compromising quality to ensure patients receive their care as scheduled
Communicates barriers effectively to avoid patient delays in care demonstrating critical thinking skills to anticipate and resolve barriers to success.
Maintains a 90% or higher audit score consistently and be receptive to constructive feedback.
Proficient in one primary service area with a firm understanding of the industry standard authorization requirements.
Able to obtain 15 authorizations daily (consideration for type of service line)