Authorizations Representative

About the job

Whitman Hospital and Medical Clinics in Colfax is hiring a full-time Authorizations Representative for day shifts. The job centers on getting prior authorizations for appointments, specialty referrals, procedures, tests and DME that providers order, and sending orders with their clinical records to the facility that needs them.

What you'll do

• Watch for incoming referral and order requests and confirm the provider has finished the needed clinical documentation
• Send referrals and authorizations, with supporting records, within 72 hours of getting them from the provider
• Check each patient's insurance to see whether an authorization is needed, and keep up with changing payer requirements
• Call insurance companies to follow up on pending authorizations and answer their requests for more information
• Tell patients whether an authorization was approved or denied, explain any visit preparation and help with scheduling
• Confirm with insurers that benefit limits have not been exceeded and let the patient know
• Work with providers to match ICD-10 codes to the requested CPT services
• Help set up peer-to-peer calls between providers and insurance plans when needed
• Serve as the go-to contact for patients and staff on referrals and authorizations, using insurer websites and exchange sites like One Health Port and Availity
• Help the Director of Clinics track workflow and efficiency

What you need

• At least one year of insurance verification experience
• Office work that is mostly seated, with occasional lifting, carrying, pushing and pulling of up to 20lbs
• Constant use of fine finger movements

Preferred

• One year of experience as an authorizations representative
• One year of work in a medical office
• One year of experience with patient registration

Schedule

• Day shift, regular full-time
• 40 hours per week

Benefits

• Medical, dental, vision and life insurance
• Retirement options, including 403(b) and 457 plans
• Medical coverage that starts on day one
• Discounts on medical services from Whitman Hospital and Medical Clinics
• A PTO plan whose accrual rate goes up with each year of service