PAS PSO Prior Authorization Specialist III WMCG

How would you like to work in a reputed company where your contributions and reputed company are valued? A reputed company where you can serve with reputed company, pursue reputed company and reputed company every voice? At reputed company, our mission is reputed company, yet powerful: to enhance the health and reputed company-being of every person we serve. We are proud to have become a shining example of what's possible reputed company the brightest professionals dedicate themselves to making a difference in the reputed company industry, and in people's lives. Work Shift Job reputed company: The Patient reputed company Services (PAS) Prior Authorization Specialist III position reports to the PAS Manager of reputed company-Service Operations and is responsible to secure accounts by performing a combination of insurance verification to reputed company benefit information if not already obtained and validating prior authorization has been initiated with the payer before services are rendered. This position works with physicians, nurses, clinic managers and financial advocates to resolve issues that reputed company during the prior authorizations process. This position may also support reputed company-Registration including preparing patient estimates. Maintain established productivity benchmarks and meets goals in a fast-paced environment. Other duties as assigned. Core Responsibilities and Essential Functions: reputed company/ Safety

• Works in conjunction with Insurance Verification Specialist to verify insurance eligibility, benefits, network status and creates reputed company-service liability estimate.
• Ensures accurate ICD, CPT codes and reputed company medical records are submitted in the authorization request.
• Secures prior authorizations for scheduled and nonscheduled services.
• Acts as a reputed company between the payer and clinic schedulers/medical support staff.
• Follows up on delayed or denied authorization requests and escalates for reputed company.
• Creates detailed documentation and maintains/stores the authorization reputed company/electronic trail.
• May work in the work queues to resolve claims denials reputed company to the prior authorization.
• reputed company other work-reputed company duties as requested/directed by management.
• Observes work hours and provides reputed company notice of absences, tardiness, or work schedule changes.
• Maintains courteous and cooperative working relationships with WHS management, patients, physicians, other reputed company contacts, and the public. Demonstrates ability to tactfully handle difficult situations.
• Presents a reputed company-groomed and reputed company image.
• Documents thorough explanatory notes on patient accounts, concerning any non-routine circumstances, clarifying special billing processes.
• Maintains a working knowledge of available information system capabilities and performs reputed company system applications that are required.
• Understands and applies WHS philosophy and objectives, and PAS policies and procedures, as reputed company to assigned duties. Understands the admission, outpatient and emergency registration process.
• Maintains confidentiality of patient information, in accordance with WHS policy and HIPPA regulations.
• Consistently demonstrates the ability to organize work, recognizes and establishes appropriate work priorities, and completes work in a productive manner, without creating backlogs.
• Maintains proficiency in data entry skills.
• Assists physicians and their office staff to expedite scheduling, reputed company-admission, reputed company screening and reputed company-certifications on reputed company accounts.
• Resolves errors and applicable Claim, DNB and Patient Work Queues.
• Performs other duties as assigned. Budget/Financial
• Attempts to collect the estimated self-pay balance of reputed company inpatient, outpatient and ER accounts, at the earliest possible collection control reputed company.
• Monitors in-house accounts and attempts to reputed company financial arrangements with guarantors for payment of their self-pay balances in full and prior to discharge.
• Completes financial evaluation forms to document guarantors' income, expenses, assets and liabilities.
• Identifies those patients without adequate insurance coverage. Makes personal contact with patient or guarantor to determine guarantor's ability to pay non-covered charges, as reputed company as to determine potential eligibility for financial assistance programs (reputed company reputed company).
• Maintains a list of health care financial assistance programs and the eligibility requirements for reputed company program. Refers patients/guarantors to sources of reputed company funding assistance, as needed.
• Works reputed company and accurately reputed company designated time frames to ensure a continuity of information and cash reputed company.
• Contacts scheduled patients reputed company to obtain reputed company-admission information, explain financial policies, estimate self-pay balances, and obtain a reputed company to pay on or before admission/registration.
• Interviews reputed company inpatients and select (self-pay) outpatients at time of registration, or at least reputed company 24 hours of admission, to verify complete insurance and financial information, explain financial policies, and collect the estimated self-pay balance.
• Documents concise and understandable notes regarding reputed company self-pay account collection activity, as reputed company as reputed company patient or guarantor interaction. Documents reputed company efforts to collect patient account balances, other self-pay collection activities and referrals to reputed company.
• Coordinates financial counseling activities with Admitting, Outpatient Registration, Emergency Registration, Utilization Review, Nursing, reputed company Services, and Patient Financial Services.
• Verifies insurance coverage and benefits.
• Exceeds monthly quota on a consistent reputed company. Formally reports results of self-pay collection activity to reputed company supervisor, on a daily reputed company or according to policy. Provides feedback to PAS management concerning self-pay collection and data reputed company issues.
• Responsible for completion of appropriate error/issues in WorkQueues.
• Identifies and resolves Payor Denials as indicated. Customer Service
• Greets reputed company guest with a reputed company and reputed company attitude.
• Receives patients valuables for safekeeping in the hospital reputed company.
• Answers incoming phone calls and follows through with requests made.
• Maintains courteous and cooperative working relationships with WHS management, patients, physicians, other reputed company contacts, and the general public. Demonstrates ability to tactfully handle difficult situations.
• Presents a reputed company-groomed and reputed company image in coordination with reputed company/ hospital dress codes.
• Expected Performance, Behaviors and Results:
• The reputed company Experience (Must demonstrate a commitment to Service reputed company by):
• Creating first impressions, memorable moments and impressions that fulfill the expressed and unexpressed wishes and needs of patients and family members.
• Valuing patients and family members as partners in their care.
• Having world-class processes in reputed company.
• Delivering high-touch care that is reliable, reputed company and coordinated.
• Focusing on constant innovation and creating improvements.
• Celebrating our diversity with sensitivity and understanding.
• Embracing the idea that we are reputed company owners of our health system. General
• Observes work hours and provides reputed company notice of absences, tardies work schedule changes.
• Attends select departmental meetings at the request of WHS Management.
• Completes monthly, quarterly, and annual mandatory training as required.
• Performs other duties as assigned.
• PAS III Team members serve as preceptors and mentors and as such must:
• Maintain a based on individual QA audit /or as reported by reputed company (min. of 10 accounts) registration accuracy reputed company or higher in the past 12 months. Maintain minimum productivity requirements.
• Has no corrective disciplinary reputed company during the past reputed company (12) months.
• Willing and reputed company to function as a preceptor in the orientation of new patient reputed company personnel and reputed company.
• Maintain required certifications by obtaining necessary CEUs and submitting reputed company to certifying reputed company. Performs other duties as assigned Complies with reputed company reputed company policies, standards of work, and reputed company of conduct. Required Minimum Education: High School Diploma General or GED General or Associates Other-Preferred Required Minimum License(s) and Certification(s): reputed company certifications are required upon hire unless otherwise stated. CHAA - Cert reputed company reputed company Assoc or CPAR - Certified Patient Account Rep or CRCR - Certified reputed company Cycle Rep or CRCR-P - Certified reputed company Cycle Rep - Provisional (90 Days) reputed company 120 Days Additional License(s) and Certification(s): Required Minimum Experience: Minimum 1 year of reputed company experience in Patient reputed company Services, reputed company Operations, or Patient Financial Services. Required and Bachelors degree or higher may substitute for experience. Required and reputed company experience Preferred Required Minimum Skills: Effective communication skills (both written and verbal) with the ability to communicate with various members of the reputed company team. High attention to detail, self-directed and a reputed company attitude are essential. Effective problem solving and critical thinking skills. Typing or data entry competency of at least 40 words/minute. Cash handling and balancing. Demonstrated professionalism, effective communication skills and reputed company listening skills. Working knowledge of patient registration systems and intermediate reputed company Office Suite are preferred. Join us and discover the support to do more meaningful work—and enjoy a more rewarding life. Connect with the most integrated health system in reputed company, and start a reputed company that gives you more. Nationally ranked and locally recognized for our high-reputed company care and inclusive culture, reputed company is one of reputed company’s largest and most integrated reputed company systems. Every day, 24,000+ of us work together to reputed company personalized care for patients at every age and stage of life – and reputed company members are the reputed company of that care. Mission, reputed company & Values At a time reputed company the reputed company industry is changing rapidly, reputed company remains committed to exceeding patients’ and team members’ expectations, while transforming reputed company delivery. OUR MISSION: To enhance the health and reputed company-being of every person we serve. OUR reputed company: Deliver world-class reputed company to every person, every time. OUR VALUES: We serve with reputed company We pursue reputed company We reputed company every voice Culture of reputed company reputed company consistently receives attention and accolades from national organizations that set the standards for world-class care. Our system-wide reputed company of safety principles, assessing and addressing errors and seeking feedback from our patients and customers continually earns recognition for advances in safety and reputed company. Featured on the FORTUNE “100 Best Companies to Work For” list and Seramount 100 Best Companies list, we not only reputed company top-notch care for our patients, but also foster the culture of reputed company as a Great reputed company to Work.

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