Prior Authorization Specialist I - CBO Prior Auth

Posted 27 Days Ago
Be an Early Applicant
Helena, MT, USA
Hybrid
Entry level
Digital Media
The Role
Coordinates insurance verification and prior authorizations for scheduled healthcare services. Acts as a liaison among patients, physicians, insurers, and hospital departments while ensuring accurate, timely authorization processing. Applies knowledge of insurance guidelines, managed care requirements, medical terminology, anatomy, and disease processes. Manages multiple deadlines and customer needs in a fast-paced environment while supporting patient care and experience.
Summary Generated by Built In

The Prior Authorization Specialist plays a critical role in supporting high-quality patient care by ensuring timely insurance verification and authorization for scheduled services. This position serves as a key liaison between patients, physicians, insurance carriers, and hospital departments to facilitate accurate and efficient authorization processes. The ideal candidate possesses strong analytical and organizational skills, a thorough understanding of insurance guidelines and managed care requirements, and a commitment to delivering exceptional customer service. Success in this role requires attention to detail, effective communication, and the ability to manage multiple priorities in a fast-paced healthcare environment while contributing to a positive patient experience.

Qualifications

KNOWLEDGE/EXPERIENCE: 

  • Sufficient experience to demonstrate ability to accept responsibility as a Hospital and Clinic prior authorization representative. 
  • Knowledge of anatomy and physiology, medical terminology and disease processes. 
  • Proficient keyboard skills and working knowledge of computer required.
  • Good verbal and written communication skills.
  • Cognitive, organizational and emotional abilities to deal effectively with multiple stressors, deadlines and customer needs.

EDUCATION: High school Diploma, HiSET or GED equivalent required. Completes Patient Financial Services I and training within first 5 months.
 

Skills Required

  • Sufficient experience demonstrating the ability to accept responsibility as a hospital and clinic prior authorization representative
  • Knowledge of anatomy and physiology
  • Knowledge of medical terminology and disease processes
  • Proficient keyboard skills
  • Working knowledge of computers
  • Good verbal and written communication skills
  • Ability to manage multiple stressors, deadlines, and customer needs effectively
  • High school diploma, HiSET, or GED equivalent
  • Completion of Patient Financial Services I and training within the first five months
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The Company
HQ: Singapore
2,500 Employees
Year Founded: 1984

What We Do

SPH Media is a leading media group, with operations in the publishing of newspapers, magazines, and books in both print and digital editions. It also owns and operates other businesses such as radio stations and outdoor media. The mission of SPH Media is to be the trusted source of news on Singapore and Asia, to represent the communities that make up Singapore, and to connect them to the world. The businesses are held by SPH Media Trust, a public company limited by guarantee.

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