MV INFUSION - INSURANCE PRE-AUTHORIZATION SPECIALIST

Posted 13 Days Ago
Be an Early Applicant
83404, Idaho Falls, ID, USA
In-Office
Entry level
Other
The Role
Verify that office visits and procedures meet insurers' medical necessity requirements and obtain pre-authorizations. Coordinate with referring offices, vendors, and coworkers to gather documentation, submit preauthorization and retro-authorization requests, and follow up to secure approvals.
Summary Generated by Built In

Mountain View Hospital is looking for an Insurance Pre-Authorization Specialist to join our team! 

JOB SUMMARY: Checks appointments and tasks/messages to make sure the diagnosis/documentation will support medical necessity, as per insurance company, and verify that all office visits and procedures that need preauthorization are pre-authorized. Works closely with referring offices to be used as a resource in helping them get necessary paperwork to start pre-authorizations, prove medical necessity, or to perform a retro-authorization. Works closely with co-workers and vendor representatives to get visits/procedures approved. 

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 Valley – all the way from Pocatello to Rexburg. Our medical capabilities span everything from wound care to urgent care, oncology to neurology, physical therapy to speech therapy, a Level III NICU, robust robotic surgery department and a continuously expanding rural health practice. 

Our work environment is mission driven, people-centric and supportive. It is what sets apart and makes people excited to come to work each day. If you are looking for a career where you can make a difference in your community, we invite you to apply. 

BENEFITS: 

Taking care for our community starts with taking care of our own team. Mountain View Hospital is proud to offer its employees competitive and comprehensive benefit packages. Benefits include: 

  • 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 

Please note benefits are based on eligibility according to full-time, part-time or PRN status classification. 

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 Valley – all the way from Pocatello to Rexburg. Our medical capabilities span everything from wound care to urgent care, oncology to neurology, physical therapy to speech therapy, a Level III NICU, robust robotic surgery department and a continuously expanding rural health practice. 

Our work environment is mission driven, people-centric and supportive. It is what sets apart and makes people excited to come to work each day. If you are looking for a career where you can make a difference in your community, we invite you to apply. 

Qualifications

Education:  High School graduate or equivalent. Knowledge of diagnoses and CPT codes for authorizing infusion 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:  Continuously able to concentrate on fine detail with interruptions and continuously able to attend to task/function for an extended period of time.  Ability to learn computer programs and input data as required.

Interpersonal:  Ability to work well with others.

Performance: Writing skills necessary to properly submit preauthorization requests with insurance companies. Appropriate phone etiquette to properly submit preauthorization requests with insurance companies.  Holds the judgment, tact and diplomacy to effectively resolve conflicts. 

Skills Required

  • High school graduate or equivalent
  • Knowledge of diagnoses and CPT codes for authorizing infusion services
  • Prior experience with coding and outpatient billing
  • Ability to communicate well with patients, co-workers, and vendor representatives
  • Ability to concentrate on fine detail with interruptions and attend to tasks for extended periods
  • Ability to learn computer programs and input data as required
  • Ability to work well with others
  • Writing skills necessary to properly submit preauthorization requests
  • Appropriate phone etiquette to properly submit preauthorization requests
  • Judgment, tact, and diplomacy to effectively resolve conflicts
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The Company
1,298 Employees
Year Founded: 2002

What We Do

Mountain View Hospital is a physician-owned facility in Idaho Falls committed to providing compassionate, cutting-edge care. Serving the Snake River Valley from Pocatello to Rexburg, the hospital and its 29 affiliate clinics offer a wide range of services, including wound care, urgent care, oncology, neurology, physical and speech therapy, and a Level III NICU, focusing on making healthcare more personal and affordable.

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