Job Description


Morrison Community Hospital
303 North Jackson Street
Morrison IL 61270


Department: Business Office

Job Title: Prior Authorization Specialist

Reports To: Business Office Director

Job Type: Full Time

Shift: Days

Job Summary

Responsible for coordinating, obtaining accurate, complete data necessary for preauthorization requests and for providing excellent customer service under the supervision of the manager. Access to information is limited to minimum necessary to perform the duties of the job.

Essential Functions

1. Receive information from physician office in a courteous and positive manner obtaining all necessary information required to complete pre-authorization process.
2. Coordinate and obtain pre-authorization approval via internet or telephone on appropriate patients, in a timely manner.
3. Enter required information accurately into appropriate databases.
4. Contact patient prior to their procedure and/or testing date to obtain all necessary account information.
5. Complete the pre-registration of all contacted patients including the demographics, physician, insurance, financial, etc.
6. Inform patients of any co-payments and/or deductibles according to their insurance plans.
7. Communicate which patients have been pre-registered with the Admitting Department.
8. Maintain knowledge of equipment and continuously learn new technology and trouble shoot equipment, report malfunctioning equipment and ensure its repair and return to service.
9. Participates in Quality Improvement projects and routine Quality and Environmental monitoring.
10. Meets department specific standards and measures.
11. Demonstrates and actively promotes an understanding and commitment to the mission of Morrison Community Hospital.
12. Maintain confidentiality of all patient, hospital and physical related information.
13. Knowledge of general hospital and department specific policies and procedures.
14. Maintain orderly condition of assigned work area.
15. Maintain a working knowledge of applicable Federal, State and Local laws and regulations.
16. Other duties as assigned.

Qualifications

1. High School graduate or equivalent.
2. Health care experience preferred.
3. Must be able to demonstrate basic computer skills.
4. Must have excellent communication skills and ability to maintain a calm professional manner in stressful situations.
5. Must be able to use independent judgment.
6. Must be willing to cross train in other insurance, billing, and ATB carrier procedures.
7. Must be comfortable operating in a collaborative, shared leadership environment.
8. Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring.

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