Job Description

The Staff Pad has partnered with a hospital in Helena, MT to hire a Prior Authorization Specialist.

Position Overview:

The Prior Authorization Specialist ensures patients receive timely care by obtaining necessary facility authorizations for services scheduled at the hospital. This role provides exceptional customer service to patients, physicians, and office staff while verifying insurance coverage and maintaining compliance with all managed care contracts and authorization policies. The Specialist communicates with external physician offices and internal hospital departments to maintain accurate patient records.

Responsibilities:

• Review and process prior authorization requests according to established criteria and protocols.
  

• Verify insurance coverage and obtain necessary authorizations, notifications, or referrals.
  

• Maintain accurate documentation in electronic systems and office records.
  

• Communicate directly with healthcare providers to gather complete and accurate information.
  

• Serve as a resource for clients and internal staff.
  

• Complete additional duties as assigned.
  

Qualifications:

• High School Diploma, HiSET, or GED required; completion of Patient Financial Services I training within 5 months.
  

• Knowledge of anatomy, physiology, medical terminology, and disease processes.
  

• Strong customer service, communication, and organizational skills.
  

• Ability to handle multiple tasks, deadlines, and customer interactions with professionalism.
  

• Proficient in keyboarding and general computer use.
  

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