Days Jobs in Worcester, MA

Obtains authorization numbers from insurance companies for imaging procedures ordered as required.

Completes regular audits and resolves issues. Works with multiple insurance carriers / vendors and keeps current with all changes as they relate to prior authorization. Communicates / interacts with specific divisions in the ASG regarding approved or denied prior authorizations. Communicates with Insurance Verification, the Central Billing Office, and other Departments to resolve prior authorization issues.

Manages the daily Missing Prior Authorization report received from Insurance Verification.

Coordinates process for authorization using defined best practices; specifically, internet applications.

Covers the front desk on a rotating basis based on coverage needs.

Works on Prior Authorizations as needed and in rotation.

Education / Training

• High school graduate or equivalent
• Certificate in insurance authorization / verification preferred.
• Business School degree preferred.

Licenses / Certification :

Required Qualifications and Skills :

Preferred Qualifications and Skills :

Essential Job Functions :

Other duties :

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. Other duties as assigned.

AGE AND DIVERSITY RELATED CRITERIA :

Consistently treats patients, colleagues and visitors with dignity and respect, while being sensitive to the differing needs of all age groups, backgrounds, characteristics, and cultures.

ABILITY TO FULFILL JOB EXPECTATIONS : Must have the ability to the perform essential functions of the position, including required work hours, locations, and physical demands, without posing a direct threat to the health and safety of themselves or other individuals in the workplace, and with or without reasonable accommodation.

PHYSICAL DEMANDS :

Prolonged periods of sitting at a desk and working on a computer.

Sturdy Memorial Hospital is an equal employment opportunity employer. There is no discrimination because of race, color, creed, age, gender, sexual orientation, national origin, veteran status or disability.