Prior Authorization and Insurance Verification Specialist

Oregon SurgiCenter has a Per Diem Prior Authorization and Insurance Verification Specialist opportunity available.

Oregon Urology Institute and Oregon SurgiCenter is one of the largest, most advanced urological centers in the Northwest. Oregon Urology Institute provides patients with some of the region's finest medical experts covering every major urological specialty using proven and leading-edge technologies.

The Prior Authorization and Insurance Verification Specialist will obtain all required authorizations prior to services being rendered at Oregon SurgiCenter including verification of insurance coverage and benefits prior to services being rendered and request prepayment if applicable.

Essential Duties:

• Verify Insurance and demographics of all scheduled patients.
• Perform benefit inquiries to determine estimated out of pocket expense.
• Notify patient of prepayment requirement and follow up as needed.
• Contact insurance carriers to obtain authorizations. Deals with insurance company representatives and others in a professional manner.
• Provide Good Faith Estimates to self-pay patients and discuss prepayment requirements.
• Stay current on insurance policies and practices for Authorizations and Benefits
• Communicate daily with other departments to ensure scheduled and add-on services are covered.
• Maintain positive relationships with Billing, Scheduling, Reception and Clinical Staff.
• Follows HIPAA guidelines to ensure patient confidentiality.
• Perform other duties and special projects as assigned by Supervisor or Manager

CONTACTS

• Physician Office Personnel
• Patients
• Insurance Company Representatives
• Facility Personnel

WORKING CONDITIONS

• Sitting, standing, and walking
• Ability to speak and hear clearly.
• Ability to read and communicate concisely via written communications.
• Uses telephone often.
• Environmental- well-lighted and ventilated with non-hazardous equipment.

REQUIRED QUALIFICATIONS:

• Knowledge of CPT & ICD10 coding and insurance reimbursement practices
• Ability to review, understand and extract relevant information from EMR.
• Strong communication skills, both written and verbal. Is courteous, cooperative understanding and empathetic towards patients, coworkers, and others.
• Attention to detail and ability to multitask in a demanding environment with good organizational skills.
• Ability to work both independently and as a team.
• Desire to strengthen skills and learn.
• Equivalent of a high school diploma

PREFERRED QUALIFICATIONS:

• Experience working in a Windows based EMR/PM
• Minimum of 2+ years' experience working in a related medical role preferred.
• Medical terminology and knowledge of surgical procedures.
• Working knowledge of healthcare insurance.

This is a per diem position No nights, weekends, or on-call.

Oregon SurgiCenter is an equal opportunity employer that is committed to fair and impartial treatment of employees, job applicants, and contractors, and to maintaining a discrimination and harassment-free work environment where people treat one another with respect. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.