Referral/Prior Authorization Specialist - Rockport Maine

Company: MaineHealth
Location: Rockport, Maine
Posted On: 04/21/2024

Summary What we do here changes the world. Working together so our communities are the healthiest in America. That's where you come in.

Once you join us you won't want to leave. We want to take care of the team that cares for our communities. Our total rewards package includes the benefits you'd expect from a top healthcare organization (benefits, insurance, etc.), plus:

Paid Time Off (PTO): The longer you stay, the more time off you'll accrue!
Life & Disability Insurance
Paid Family Leave
Tuition reimbursement
Build your future with our awesome retirement/pension plan!
Wellness programs that include: Health and well-being, employee assistance, financial and emotional well-being, healthy payback programs and much more!


How did we become recognized as one of America's Best Large Employers in 2022 by Forbes? It's simple: we believe in investing in our care team.



You're valued. In 2021 alone, MaineHealth invested over $100 million in compensation for our team.
Your safety comes first. We prioritize the health and safety of all care team members, providing appropriate personal protective equipment, testing and access to additional wellness benefits.
Your career matters. Learn and grow with MaineHealth through our training and education opportunities.




Your Role:

The Referral/Prior Authorization Specialist will complete referrals and pre-certifications generated from Pen Bay's physician practices based on the given insurance. This position will work closely with all physician practices, fiscal services, radiology, and other hospital departments as necessary. This position will call patients and verify insurance information as needed. This position will review, for precertification, outpatient testing orders.

Required Minimum Knowledge, Skills, and Abilities (KSAs):




Education: High school diploma preferred.
License/Certifications: N/A
Experience: 3+ years of experience in hospital billing and/or physician practice setting, preferred.
In depth knowledge of referral and pre-certification process/requirements for different insurance companies, preferred.
Excellent interpersonal, teamwork and communication skills a must.
The ability to work in a fast paced and time sensitive environment.
In depth knowledge of hospital computer systems, preferred.
Travel to physician offices may be required.


More...

    

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