Prior Authorization Specialist III

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Wellstar Health System

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1992

⚕️ Healthcare Insurance

Healthcare Insurance

Wellstar Health System is a comprehensive healthcare organization dedicated to providing personalized and compassionate care to patients in Georgia and South Carolina. With a diverse range of career opportunities, Wellstar supports its employees' career growth and wellbeing through a positive culture, excellent benefits, and a focus on diversity, equity, and inclusion. The organization emphasizes the importance of treating both patients and staff with respect and care, making it a sought-after workplace in the healthcare industry. Wellstar is committed to offering high-quality healthcare services and maintaining strong community engagement.

📋 Description

• Secure accounts by performing a combination of insurance verification to gather benefit information • Validate prior authorization has been initiated with the payer before services are rendered • Work with physicians, nurses, clinic managers, and financial advocates to resolve issues during the prior authorization process • Support Pre-Registration including preparing patient estimates • Maintain established productivity benchmarks • Follows up on delayed or denied authorization requests and escalates for resolution • Creates detailed documentation and maintains/stores the authorization paper/electronic trail • Assist physicians and their office staff to expedite scheduling, pre-admission, Medicaid screening and pre-certifications on all accounts

🎯 Requirements

• Minimum 1 year of healthcare experience in Patient Access Services, Practice Operations, or Patient Financial Services • Effective communication skills (both written and verbal) with the ability to communicate with various members of the healthcare team • High attention to detail, self-directed and a positive attitude are essential • Effective problem solving and critical thinking skills • Typing or data entry competency of at least 40 words/minute • Cash handling and balancing • Working knowledge of patient registration systems and intermediate Microsoft Office Suite are preferred

🏖️ Benefits

• Health insurance • Professional development opportunities