The Authorization Specialist is responsible for creating hospital encounters for surgical services throughout Park Nicollet Ambulatory Surgery Centers and Methodist Hospital. This position is responsible for completing insurance verification, obtaining and documenting prior authorization approvals from insurance companies for procedures and hospital stays. In collaboration with the Care Team, the Authorization Specialist will obtain and submit clinical documentation pertinent to the specific services requiring authorization for payer review. The Authorization Specialist will maintain and update documentation as it relates to changes in payer prior-authorization, pre-certification and notification requirements by reviewing insurance payer bulletins and publications. This position must attend continuing education classes and complete mandatory training in order to maintain department specific requirements and professional growth. Effective performance of these functions helps the organization achieve strong cash flow and maximize patient’s satisfaction. Education/Experience: Required education/experience includes:
• High school diploma or equivalent.
• Demonstrated P/C and keyboard experience.
• Demonstrated customer service skills.
• Demonstrated written/verbal communication skills. Preferred education /experience includes:
• Post high school degree or certification.
• Healthcare registration experience.
• Healthcare revenue cycle experience. 2 years previous healthcare experience which may include medical terminology, insurance eligibility, prior-authorizations, but not limited to ICD/CPT coding Special Knowledge/Skills/Certifications/Licenses:
• Knowledge of EPIC registration and/or any electronic health record
• Ability to work cohesively and respectfully with a diverse work force and patient population.
• Ability to utilize critical thinking skills while working through complex situations
• Knowledge of patient eligibility and related systems
• General knowledge of hospital billing cycle
• Demonstrates effective time management skills and problem solving skills
• Communicates effectively and maintains composure under stressful situations
• Ability and expectation to successfully complete a competency examination on insurance selection/process upon completion of training and annually thereafter.
• Ability and expectation to demonstrate competency on insurance selection/process on a monthly basis.
We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.
The OrganizationAt Park Nicollet you're part of something bigger. We're a member of the HealthPartners organization, an award-winning integrated health care system comprised of several organizations. HealthPartners includes a team of 21,000 people dedicated to making a difference for our members, patients and the community. Whether you want to work in direct patient care, or support those who do, you will find a vast variety of job opportunities. Here, your contributions help to improve lives and impact health care for the better. If you want to make a difference, we want you on our team.Park Nicollet Mission, Vision and ValuesMission: Our mission is to improve health and well-being in partnership with our members, patients and community.Vision: Health as it could be, affordability as it must be, through relationships built on trust.Values:Excellence We strive for the best results and always look for ways to improve.Compassion We care and show empathy and respect for each person.Partnership We are strongest when we work together and with those we serve.Integrity We are open and honest, and we keep our commitments.What makes us unique?At Park Nicollet, we never forget why we're here. Your health and well-being is our top priority and is at the forefront of everything we do. We believe outstanding health care is delivered when we merge the science and intellect of medicine with the compassion, spirit and humanity of our hearts. We refer to this as “Head
• Heart, Together,“ and it exists to inspire constant improvement and lasting success. We achieve this by partnering with patients and families in everything from care decisions to service and facility design. As we work together as a unified team, we engage patients, families and the community, and put them at the center of everything we do.To learn more about our organization, including our award winning care, please visit our website at www.parknicollet.com.