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Job Summary: The Pre-Authorization Specialist is a member of the Utilization Review Department who is responsible for verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to the delivery of inpatient, outpatient, and ancillary services. This individual determines which patient services have third-party payer requirements and is responsible for obtaining the necessary authorizations for care, via phone, fax, or payer websites. The Pre-Authorization Specialist provides detailed and timely communication to both payers and clinical partners in order to facilitate compliance with payer contractual requirements and is responsible for documenting the appropriate information in the patient's record. Other duties as assigned.

Qualifications: High school diploma or equivalent required; Associate's degree preferred. Three to five years of progressive responsibility and experience in access management/business services. Working knowledge of registration, patient accounting, and information systems related to a healthcare environment. Thorough skills in managing and motivating people. Considerable ability to communicate effectively.

EOE AA M/F/Vet/Disability