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Prior Authorizations Representative | Full Time, Days US - Remote (Any location)

Work from home Full-time role Hiring

Job Family: Admitting Representative Travel Required: None Clearance Required: None What You Will Do: Under the direction of the Patient Access Registration Manager, this position is primarily responsible for all insurance notification, verification, and authorization activities necessary to financially secure accounts. Responsibilities include interacting with insurance companies, patients, physician offices and other hospital departments to thoroughly document accounts. Explains financial requirements to patient or other responsible party and collects deposits or deductibles as required. Position Type: Full Time, Day Shift Schedule: Monday - Friday, 8:30am - 5:00pm Location: 100% Remote Please Note: Schedule is subject to change based on hospital census and the needs of the business. The selected candidate must reside within 100 miles of Birmingham, AL. Duties and Responsibilities:

  • Performs insurance notification, verification, and authorization activities necessary to financially secure accounts.
  • While appropriately prioritizing work based on financial risk / difficulty, incumbent completes notification, verification, & authorization for all inpatient, Ambulatory Surgery and bedded outpatient admissions utilizing the HQ work list as the primary work driver.
  • In a courteous manner, coordinates with and disseminates information to referring physician/hospital clinical staff and the insurance company to ensure that scheduled accounts are secure prior to admit and non-scheduled accounts are secure 24 hours post admit.
  • Aggressively explores all possible options to secure an account when problems arise (i.e. contacting physician office, referencing past visits, contacting patient, etc.).
  • Communicates with insurance companies, patients, physician offices and/or other hospital departments to complete account documentation requirements Responsible for securing patient accounts.
  • Explains financial requirements to patient or other responsible party. Collects deposits and deductibles.
  • Aggressively explores all possible options as a means of securing an account when problems arise.
  • Informs Patient Access management, registration staff and physician if account is not secure prior to admission.
  • Coordinates with and disseminates information to referring physician/hospital clinical staff and insurance company to secure scheduled accounts prior to admission and non-scheduled accounts within 24 hours following admission.

What You Will Need:

  • High School Diploma or equivalent
  • 1-3 years of prior relevant experience

What Would Be Nice to Have:

  • Ability to type a minimum of 35 WPM.
  • Familiarity with medical terminology
  • CPAR or CHAA certification

#IndeedSponsored #LI-DNI The annual salary range for this position is $38,000.00-$64,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs. What We Offer: Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace. Benefits include:

  • Medical, Rx, Dental & Vision Insurance
  • Personal and Family Sick Time & Company Paid Holidays
  • Position may be eligible for a discretionary variable incentive bonus
  • Parental Leave
  • 401(k) Retirement Plan
  • Basic Life & Supplemental Life
  • Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
  • Short-Term & Long-Term Disability
  • Tuition Reimbursement, Personal Development & Learning Opportunities
  • Skills Development & Certifications
  • Employee Referral Program
  • Corporate Sponsored Events & Community Outreach
  • Emergency Back-Up Childcare Program

About Guidehouse Guidehouse is an Equal Opportunity Employer–Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation. Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco. If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at [email protected]. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation. All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or [email protected]. Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse. Note that Guidehouse will never charge a

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