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Posted: 11-Jan-25
Location: Lewiston, Idaho
Internal Number: 529593
The work location for this position is Lewiston, Idaho
Full-Time: 80-hrs per pay period
Hours: 8:00am - 4:30pm
Benefits May Include:
- Medical, Dental, Vision
- 401k w/ employer match
- Short & Long-term disabilities
- Life & AD&D insurances
- Employee Assistance Program
- Pet Insurance
- and more?
Position Summary
Assists in coordinating the activities between scheduling, insurance verification, and pre-certification. Collaborates with a variety of personnel and departments to ensure smooth clinic operations.
Primary (Essential) Duties:
- Verifies coverage and ensures all insurance requirements are met, as well as obtaining all prior authorization and/or referrals as appropriate prior to patient arrival.
- Works with patients, physicians, charge capture specialists, and third-party representatives as necessary to obtain authorizations.
- May require reviewing insurance company websites for assistance in determining which services require preauthorization. Assures precertification is complete by direct call to insurance companies or by checking with physicians? offices. May recommend re-scheduling of procedures if appropriate, so that pre-admit criteria may be met.
- Obtains initial and subsequent insurance authorization and pre-certification for chemotherapy services, surgeries, outpatient testing, labs, and imaging.
- Handles phone calls from patients regarding prior authorization questions for services ordered/scheduled.
- Maintains a close working relationship with the site Patient Financial Counselor.
- Stays current with insurance requirements.
- Establishes priorities and accomplishes tasks in a timely manner.
- Covers for and assists with other front office functions as requested.
- Performs other duties as assigned.
- Ability to work effectively under pressure with deadlines and exhibit an appropriate sense of urgency
Scion Health considers a consistently positive, cooperative, self-motivated, courteous, and professional attitude to be an essential function of every position. While different positions have different primary areas of responsibility, everyone needs to work as a team, and we expect all employees to roll up their sleeves and pitch in as necessary to get the job done.
Employees must be able to relate to other people beyond giving and receiving instructions: (a) can get along with co-workers or peers without exhibiting behavioral extremes, (b) perform work activities requiring negotiating, instructing, supervising, persuading, or speaking with others; and (c) respond appropriately to constructive feedback from a supervisor.
While this job description is intended to be an accurate reflection of the requirements of the job, management reserves the right to add or remove duties from particular jobs when circumstances (e.g., emergencies, changes in workload, rush jobs or technological developments) dictate.
Qualifications- High school graduate or equivalent with courses in English and typing.
- Knowledge of insurance is required.
- Demonstrated clerical skills required, preferably in a medical setting.
- Completion of a Medical Secretary program may be substituted for experience.
Must possess good oral and written communication skills, knowledge of medical terminology, type 45 wpm accurately, and be able to make simple math calculations. Must be able to read and comprehend complex written material, operate office equipment including computer terminals, and observe rules of confidentiality. Must become thoroughly familiar with specific hospital policies and procedures for admission and outpatient registration and with Medicare, Medicaid, and insurance pre-admission requirements and criteria. Must become familiar with various insurance benefit plans, billing requirements, and hospital credit/collection policies.
WORKING CONDITIONS
Involves standing, sitting, and walking to various departments during each shift. Some stress is created by ever-increasing volume and ongoing changes in prior authorization requirements imposed by government and commercial insurance companies.
GENERAL POSITION INFORMATION
The position is essential for the functioning of the St Joseph Cancer Center and Blood Institute. The workload is generated by the number of patients the providers encounter each day. Requires the ability to make decisions and judgments based on knowledge and experience.