Job Description

Overview

PAIN & SPINE - INSURANCE PRE-AUTHORIZATION SPECIALIST at Mountain View Hospital. This role involves reviewing and processing preauthorization requests to ensure medical necessity is supported by documentation and insurance company requirements.

Responsibilities

• Checks appointments and tasks/messages to verify that the diagnosis/documentation will support medical necessity and that all office visits and procedures that require preauthorization are pre-authorized.
• Collaborates with referring offices to obtain necessary paperwork to start pre-authorizations, prove medical necessity, or perform a retro-authorization.
• Works with co-workers and vendor representatives to obtain approvals for visits and procedures.

About Mountain View

Mountain View Hospital and our 29 affiliate clinics are committed to providing compassionate, cutting edge care to our patients. We serve the entire Snake River Valleyfrom Pocatello to Rexburg. Our capabilities span wound care, urgent care, oncology, neurology, physical therapy, speech therapy, a Level III NICU, a robust robotic surgery department, and a growing rural health practice. Our work environment is mission driven, people-centric and supportive. If you are looking for a career where you can make a difference in your community, we invite you to apply.

Benefits

• Medical, Dental and Vision Insurance
• Paid Time Off (vacation, holidays and sick days) and Medical Paid Time Off
• Retirement Plans (401K with up to 6% match)
• Earned Quarterly Bonus Program
• Education Reimbursement Program
• Discount for medically necessary procedures performed at Mountain View Hospital and Idaho Falls Community Hospital
• Note: Benefits are based on eligibility according to full-time, part-time or PRN status

Qualifications

• Education: High School graduate or equivalent. Knowledge of diagnoses and CPT codes for pain management services preferred.
• Experience: Prior experience with coding and billing for outpatient billing is preferred.
• Language/Communication: Ability to communicate well with patients, co-workers and vendor representatives.
• Mental Capabilities: Ability to concentrate on fine detail with interruptions and to attend to tasks for an extended period. Ability to learn computer programs and input data as required.
• Interpersonal: Ability to work well with others.
• Performance: Writing skills to properly submit preauthorization requests with insurance companies. Appropriate phone etiquette to submit preauthorization requests. Demonstrates judgment, tact and diplomacy to resolve conflicts.

Employment type

• Full-time

Job function

• Sales and Business Development

Industries

• Hospitals and Health Care

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