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Avera Health

Insurance Specialist - Spencer Hospital

Avera Health, Spencer, Iowa, United States, 51301

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Location:

Spencer, IA

Worker Type:

Regular

Work Shift:

Day Shift (United States of America)

Spencer Hospital is proud to employ highly skilled and caring staff members. We offer competitive salaries and benefits as well as a pleasant work environment.

Position Highlights Spencer Hospital is a rural hospital allocated in northwest Iowa employing over 500+ employees. Positions at Spencer Hospital are not affiliated with Avera; however, we collaborate to provide services to the communities we serve. Employment offers, if accepted, are exclusively with Spencer Hospital.

Responsibilities

Coordinate with clinical staff in order to complete prior authorization for all services and procedures in an accurate and timely manner

Ensure that all supporting documentation is available and shared with payers to expedite authorizations

Maintaining authorizations, which includes gathering necessary documents to support authorization requests, submitting initial requests for authorization, following up on authorization requests, and communicating with departments and providers on status of authorizations

Coordinate with providers as needed to ensure treatments/services meet medical necessity criteria. Assist with appeals for claim denials due to the authorization process. Develop and implement prior authorization workflow, policies and procedures

Collaborate with other departments to assist in obtaining pre-authorizations in a cross functional manner. Share information with providers and staff regarding coverage criteria, medically necessary criteria

Requirements

High school graduate or equivalent

Prior hospital and/or clinic authorization experience preferred

Schedule

72 hrs per pay period

M-F; 8a-4:30pm

The schedule may fluctuate based upon needs of the department

Spencer Hospital offers competitive wages, affordable insurance, IPERS retirement, in-house education, paid time off, family gym membership and so much more!

Please contact Spencer Hospital Human Resources for any questions at 712.264.6205 or email hr@spencerhospital.org.

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