PRE AUTHORIZATION 340B SPECIALIST

JOB REQUIREMENTS Education College degree with emphasis on healthcare, accounting, or business is preferred. OR A high school graduate with registration or business office experience. Experience Pre-Authorization experience preferred. Two years in registration or business office is recommended. Physical This is a safety sensitive position. Please see the St. Bernards Substance Abuse Policy for further information. Normal hospital environment. Close eye work. Hearing within normal range. Operates calculator, computer, telephone, copier, general office equipment. Continuous sitting. Occasional walking and bending within the work area. Lifting, carrying, pushing and pulling charts and office supplies up to 20 lbs. JOB SUMMARY The Pre-Authorization Reviewer is responsible for collecting appropriate pre-authorization information and verifying coverage of patients admitted under group or private insurance plans. Must be able to converse with insurance company and review agency representatives and possess communication skills to provide needed information in a clear and concise manner. Is responsible for providing information from insurance companies and/or review agencies to appropriate medical center departments in an orderly and timely manner. Pre-Authorization Reviewer will work closely with Business Office, Medical Records, Scheduling, Registration, and Administration to assure insurance process and utilization review flows smoothly. Maintain good relations with clinics and clinical staff in a positive, professional manner.