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Job description
Authorization SpecialistThe Authorization Specialist position is responsible for reviewing requests for prior authorization of medical services including elective and outpatient surgeries and procedures, home health, out of network requests, and expedited requests for medical necessity in accordance with government, commercial, and workers compensation health plan coverage guidelines. This individual is responsible for benefit determination and documenting completely and accurately in accordance with healthcare system guidelines. This position works well independently solving problems and acts as liaison with others outside the department to create smooth workflows and transitions of information needed for authorizations. Promotes harmonious and efficient intra and inter departmental relationships and delivers quality customer service. Adheres to the Mission, Vision, Values and Philosophy of the departments and Saint Francis Healthcare System. Constantly works with and maintains restricted or confidential information from many sources within the healthcare system. Any and all duties as assigned by Manager and Director.Job Details and RequirementsEducation:High school graduate or equivalent required.Experience:- One year of experience in a healthcare setting obtaining insurance authorizations strongly preferred.- Experience with CPT and ICD codes is a plus.Mission That MattersAt Saint Francis, you're not just doing a job - you're part of a Catholic healing ministry rooted in compassion, dignity, and service. Every action is inspired by a commitment to honor human life and care for every person who walks through the doors.MissionTo provide a ministry of healing, wellness, quality, and love inspired by our faith in Jesus Christ.VisionTo be a leading Catholic healthcare system that celebrates and protects the gift of life by providing exceptional patient outcomes in quality, safety, access and value.Values You Can Feel Every DayIntegrity: Doing what's right, even when no one is watchingStewardship: Managing resources wisely for the futureFaith: Believing in a purpose greater than ourselvesHope: Lifting up those who feel discouragedJoy: Serving others with a grateful, happy heartCompassion: Seeing others through Christ's eyesExcellence: Always striving to be the bestDignity: Respecting human life from beginning to endTotal RewardsOur most important asset is our colleagues. That's why Saint Francis Healthcare System offers a comprehensive benefits program to meet all your needs. Colleagues working at least 24 hours per week will have access to our Total Rewards package as outlined below.Comprehensive and affordable health coverage including medical, prescription, dental and vision - available on the first of the month after hire dateSaint Francis Medical Services DiscountEarned Time Off (ETO) based on relevant years of work history. ETO combines vacation, sick, holidays, and personal days into one balance to allow for flexibilityRetirement benefits including SFHS immediate matchingEducation Assistance benefits up to $5,000 per calendar year for one year of service after graduationOther benefits including: Benefit Support through Health Advocate, Employee Assistance Program, Flexible Spending Accounts, Identity Theft Protection, Pet Insurance, Earned Wage AccessSaint Francis Healthcare System provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, sexual orientation, gender identity, or genetics. In addition to federal law requirements, Saint Francis Healthcare System complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
Worksite address
cape girardeau, MO, 63701, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.