Prior Authorization/Office Clerk

*Prior Authorization* Johnson County Healthcare Center (JCHC) is an integrated healthcare center featuring a 25-bed critical access hospital, a 44-bed nursing home, an outpatient clinic and a home health and hospice program.
JCHC serves residents of Johnson County, Wyoming, with a population of approximately 8,500 spread across 4,175 square miles.
*Our Mission:* Excellence in healthcare, delivered with compassion.
*Prior Authorization Job Responsibilities:* * This position obtains all needed information for inpatient and outpatient admissions, makes sure all the necessary papers are signed and obtains Prior Authorization for all inpatient and observation admissions and all outpatient procedures.
* Prioritizes the urgency of the authorization by anticipating the approximate time it may take to obtain the authorization from the insurance company.
* Follows up and secures prior authorization for inpatients, observation, and outpatient procedures.
This position coordinates prior authorization information with appropriate departments as needed.
* Runs insurance eligibility verification prior to obtaining authorizations * Answers incoming calls, screening as necessary and transferring as requested; greets and directs employees, visitors, patients, business representatives and the general public arriving at the facility; provides general information regarding the facility and department functions and procedures.
* Address & corrects registration insurance edits.
Adds new Insurances in the insurance company tables as needed.
* Assigns provider numbers for orders received from outside physician.
* Coordinates utilization with hospital D.
O.
N * Coordinates patient observation time units with the hospital D.
O.
N * Works closely with hospital billers on denials related to authorizations.
* This position performs all necessary outpatient and inpatient documentation for the Business Office and must prioritize duties on a daily basis, any problems or concerns are referred to the Business Office Manager.
* This position maintains the hospital Machine-Readable patient estimator on our website & other locations.
* This position provides Patient Liability Estimates as requested for uninsured patients, or insured when requested.
* Addition tasks when asked or as needed.
*Prior Authorization Accountabilities:* * Maintains designated inpatient and outpatient documents to ensure accurate documentation, prompt retrieval and compliance with established standards and regulations.
* Performs clerical duties and any related task to maintain a smooth flow of work in the Hospital Business Office.
* Performs work efficiently to contribute to an economical operation.
* Checks and inspects own work to ensure that it has been properly performed.
* Follows established policies and procedures to ensure the continuity of department and facility operations.
* Consistently demonstrate skilled communications and troubleshooting techniques.
* Abide by the Health Insurance Portability and Accountability Act (HIPAA) Privacy Regulations, as set forth in the adopted Johnson County Healthcare Center HIPAA policies and procedures, as we as department-specific policies and procedures regarding disclosure and use of Protected Health Information PHI.
* Understand and practice Universal Precautions, Category lll.
*Hours, Salary & Benefits:* * This is a full-time (40 hours per week) position.
* Salary depends on education and experience level.
* Health insurance, life insurance, and retirement options.
* Benefits available to all full-time employees *Prior Authorization Skills and Qualifications:* * Use of Office Equipment * Computer * Photocopier * Document Scanner * Postage Meter * Microsoft Office Skills * Ability to Learn and Follow Procedures and Practices * Organization and Time Management Skills * Professionalism * Problem Solving * Verbal Communication *Education and Experience Requirements:* * High school diploma or equivalent education required * Experience in Billing, Medical Terminology, and/or Prior Authorization preferred * Understanding of CPT codes & diagnosis codes is not required but helpful * Knowledge of appropriate software including: Microsoft Word, Excel, and Outlook, Microsoft PowerPoint and Adobe Acrobat Job Type: Full-time Pay: $20.
25 - $23.
10 per hour Expected hours: 40 per week Benefits: * Dental insurance * Employee assistance program * Health insurance * Health savings account * Life insurance * Paid time off * Referral program * Retirement plan * Vision insurance Weekly day range: * Monday to Friday Education: * High school or equivalent (Preferred) Work Location: In person