<p>Description</p> <p>Tanner Clinic has an immediate opening for a Prior Authorization Specialist.</p> <p>Location: Kaysville, UT</p> <p>Hours: Fulltime</p> <p>Essential Job Responsibilities:</p> <ul> <li>Obtains pre-authorizations/pre-certification per payer requirements for services and ensures authorization information is documented appropriately. </li><li>Verifies physician orders are complete, determines CPT, HCPCS and ICD-10 codes for proper authorization. </li><li>Ability to understand and communicate insurance co-pays, deductibles, co-insurances, and out-of-pocket expenses for point of service collections. </li><li>Communication is maintained with providers, clinical staff, and patients in relationship to authorization status. </li><li>Remains current with insurance requirements for pre-authorization and provides education within the departments and clinics on changes. </li><li>Keep informed of changes in the authorization process and insurance policies </li><li>Aid team members in maintaining turnaround times. </li><li>Account for internal control responsibilities in line with the department objectives. </li><li>Ability to handle Protected Health Information in a manner consistent with the Health Insurance Portability and Accountability Act (HIPAA). </li><li>Answer questions and offer other information, as requested, to provide patient-focused service and a positive impression of the organization. </li><li>Other duties as assigned by the supervisor or manager. </li></ul> <p>Requirements</p> <p>Education:</p> <ul> <li>High school diploma or equivalent </li><li>Medical Assistant or higher </li></ul> <p>Experience:</p> <ul> <li>3-5 years of experience working in a hospital, doctor's office, or pharmacy setting with knowledge of procedures and/or medication authorization experienced required. </li><li>1-2 years procedure and/or medication authorization experience preferred. </li></ul> <p>Other Requirements:</p> <ul> <li>Regular and reliable attendance is an essential function of the job. </li></ul> <p>Performance Requirements:</p> <p>Knowledge:</p> <ul> <li>Knowledge of CPT, HCPCS, and ICD-10 codes. </li><li>Knowledge of medical terminology and departmental services. </li></ul> <p>Skills:</p> <ul> <li>Basic computer skills (Microsoft Office Suite). </li><li>Basic problem-solving skills. </li><li>Possess pleasant and effective written, verbal, and telephone communication skills. </li><li>Must possess excellent time management and organizational skills. </li><li>Must possess multi-tasking skills. </li></ul> <p>Abilities:</p> <ul> <li>Ability to maintain a professional demeanor during stressful situations. </li><li>Ability to solve conflict. </li><li>Ability to use multi-line phone system, including transferring calls and paging. </li><li>Prevents, calms, or defuses irate callers and patients by working with them to identify concerns and properly directs calls. </li></ul> <p>Equipment Operated:</p> <ul> <li>Standard office equipment including computers, fax machines, copiers, printers, telephones, etc. </li></ul> <p>Work Environment:</p> <ul> <li>Position is in a well-lit office environment. </li></ul> <p>Mental/Physical Requirements:</p> <ul> <li>Involves sitting approximately 90 percent of the day, walking or standing the remainder. </li></ul>