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Prior Authorization Representative

Company: Aspen Valley Hospital
Location: Rifle
Posted on: June 9, 2021

Job Description:

Company Overview:

Embrace the adventure of a career at Aspen Valley Hospital. Aspen Valley Hospital is a twenty-five bed community hospital that represents the best of two worlds - the warmth and friendliness of a small town and the technical expertise of a major medical center. Our Award Winning Hospital, nestled in the heart of Aspen, CO, includes a team of more than 500 people dedicated to making a difference for our patients, families, and community. Nationally we are recognized for providing some of the most exceptional patient care of any hospital across the country.

This position is located in our remote office in Glenwoods Springs, CO. This is a fulltime position (40 hours per week) with full benefits and competitive compensation. This position is Monday thru Friday.

Ideal candidates will have some healthcare or health insurance experience (preferred, not required), are team players(required), will be computer proficient (required) and career minded (required). Having a friendly and highly professional demeanor is also requirement.

Primary Scope of Responsibilities:

* Accurately schedules appointments, choosing appropriate appointment types, and correct data entry. Professional & responsive communication with physicians, patients, and departments. * Produces day end reports & distributes. Includes reviewing scanned orders, correct procedure vs. actual order, and ABN if needed has been processed & distributed accordingly. * Works with other PFS staff to ensure fiscal management of appointments. Stays current on Medicare & insurance requirements, ensuring ABN's & insurance waivers & pre-certs

are completed & communicated to patient & scanned. * Understands and complies with all Hospital, patient confidentiality, ABN's and insurance waivers. Participates in trainings & staff meetings. Reads daily summary reports & emails to be aware of changes. * Utilizes computerized scheduling and B/AR modules to maximize benefit for AVH and customers. Adapts software to meet needs. * Provides assistance to other departments as needed. * Fiscal responsibility including reviewing and completing ABN's, Insurance authorizations/waivers, and ensuring completed precertification as needed. * Schedules and pre-certifies all Physical Therapy patients-at all AVH locations. Reviews and monitors CAP requirements and ABN's for Medicare patients. Pre-certify and/or check for MCR ABN on all patients with scheduled lab tests-at all AVH locations. As above does all pre-certification, insurance authorizations and waivers, required ABN's and CAPS. * Records pertinent documentation in accordance with regulatory requirements, professional standards and hospital policy. * Adheres to federal, state and hospital rules and regulations concerning HIPAA privacy and security. * Follows Hospital compliance plan and policies, including the Code of Conduct. * Participates in required training for compliance related activities (HIPAA, Compliance, Patient Safety, TJC, etc.)

EDUCATION/EXPERIENCE REQUIREMENTS 2-3 years of experience in related healthcare field preferred

KNOWLEDGE AND SKILL REQUIREMENTS Ability to concentrate and show attention to detail Strong interpersonal skills required Ability to work independently

*Our hire-in rates of pay are based on years of relevant experience. Listed below are our hire-in rates for the position, which includes: minimum pay (no relevant experience) and mid-point (12 or more years).

Minimum = $19.15/hr

Mid-Point = $24.90/hr

Our comprehensive benefits package includes generous Paid Time Off, Health Insurance within your first 30 days, Retirement, and much more can be viewed here.

Previous professional experience that would be helpful, but not required, would be: Insurance Verification, Insurance Rep, Scheduling, Health Insurance, Health Care Insurance, Healthcare Scheduling, Hospital Scheduling, Medical Insurance, Clinical Coordinator, Entry Level Health Care positions, Paid Training, On the job training, Medical Scheduler, Hospital Administrative Assistant

Keywords: Aspen Valley Hospital, Snowmass , Prior Authorization Representative, Other , Rifle, Colorado

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