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Empowering the Hands that Heal

Prior-Authorization Coordinator - PRN

Lewiston, Idaho

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Overview

ScionHealth strives to provide quality-driven, patient-centered acute and post-acute hospital solutions. The health system is focused on driving innovation, serving its communities, and investing in people and technology to deliver compassionate patient care and excellent health outcomes. Based in Louisville, ScionHealth operates 79 hospital campuses in 25 states – 61 long-term acute care hospitals and 18 community hospital campuses and associated health systems.

Success Profile

What do you need to be successful at ScionHealth? Here are the top traits we’re looking for:

  • Communicator
  • Creative
  • Deadline-oriented
  • Goal-oriented
  • Problem-solver
  • Strategic

Our Culture

  • Driven by quality: We believe that if we focus on delivering quality care, exceeding expectations related to customer service and supporting our people, our business results will follow.
  • We equip our hospitals and our people with the resources, technology and expertise they need to deliver the best possible care to patients.
  • We’re always looking to find better ways to support caregivers by improving what we do, sharing best practices, and responding to the changing needs of our people and the patients they serve.
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Quote

“ScionHealth allows leaders to inspire the organization to take responsibility for creating a better future.”

Jarrell King Talent Acquisition
Jarrell King, Talent Acquisition

Prior-Authorization Coordinator - PRN

Lewiston, Idaho
Facility St. Joseph Regional Medical Center
Req ID 529297 Post Date 12/06/2024 Category Administrative
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Description

The work location for this position is Lewiston, Idaho

This is a PRN position (On-Call - No Benefits) - you will receive an additional 15% PRN pay in lieu of benefits

Hours: 8:00am - 5:00pm

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 preauth.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
  • The above statements reflect the general duties considered necessary to describe the principal functions of the job as identified and shall not be considered as a detailed description of all the work requirements that may be inherent in the position.

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
  • Knowledge of insurance
  • 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
  • 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.

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Benefits

  • Career Development

    We support growth and development for all our employees through various means and in programs designed to foster inclusion.

  • Healthcare

    Your health is important to us. We offer a comprehensive benefits program and resources to support healthy lifestyles for you and your family.

  • Retirement Plan

    Employees can contribute to their retirement with plans that allow for pre-tax or after-tax contributions through payroll deductions.

  • Paid Time Off

    With paid holidays and unlimited PTO, you are encouraged to take the time you need to relax and recharge with family and friends.

  • Work-Life Balance

    Work-life balance is not just a perk, it is encouraged. We believe that our employees work their best when they’re allowed to be their best selves in and out of the office.

  • Miscellaneous Benefits

    Whether you’re looking for pet insurance, identity theft protection, or select discounts from hundreds of local and national merchants, we have a variety of benefits that help provide peace of mind.

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