Provider Network Specialist jobs in Benton Harbor, MI

Description

 Become part of a Migrant and Community Health Center, where you will:

• Have a passionate purpose.
• Do worthwhile work.
• Make a difference in people’s lives.

InterCare is searching for a full-time Prior Authorization Specialist to join our Dental team! At InterCare, you’ll find a rewarding and challenging work environment, competitive compensation and benefits package which includes:

• Vacation/personal paid time off,
• Sick time,
• 10 paid holidays,
• Tuition reimbursement program,
• Medical, prescription, dental, vision, life insurance, and short term and long term disability insurance.

At InterCare Community Health Network, we believe all people have the right to equal access to quality health care.

Work Schedule:

Hours of work are Monday through Friday, 40 hours/week. 

Requirements

Primary Accountability

The Prior Authorization Specialist (PAS) is responsible for obtaining authorization from insurance carriers for dental services that require prior authorization.

Prior Authorization/Scheduling is responsible for scheduling and obtaining prior authorization for diagnostic tests, surgical procedures as ordered by referring physicians. Clinical knowledge will be required to research patient charts to justify many of the prior authorizations. Possess careful attention to detail/works closely with physicians, hospital scheduling and billing departments. Works quickly, accurately and independently to meet daily expectations of productivity. Primary goal is to facilitate a positive consumer experience.

Description of Primary Duties & Responsibilities

• Schedules, updates, cancel, and reschedules OR time(s) and Pre-Ops for patients. 
• Prepare pre-registration, routing forms, and physician orders.
• Obtains required prior authorizations for outpatient procedures.
• Complete authorizations prior to scheduling appointments.
• Informs patient and/or Dental staff of the proper preparation and instructions for test orders
• Communicates with Dentist(s), hospital departments, and insurance companies to resolve authorization issues
• Thorough understanding of all insurances
• Works cooperatively in a team environment
• Schedules patients directly via hospital scheduling system.

Required Qualifications:

• A Bachelor's degree or an equivalent combination of education and experience.
• eCW experience preferred.
• Excellent written and verbal communication skills.
• Strong organizational skills.
• Proficiency in technology such as Microsoft Office, Electronic Health Records, Outlook, and other clinic software.
• Demonstrates knowledge of effective strategies for working with diverse faculty, staff, and students.
• Previous work with insurance prior authorizations, denials and CPT codes.

Professional and Technical Knowledge

Possesses a thorough understanding of theory and practices of typically acquired through completion of a bachelor’s degree program and/or extensive practical experience in a professional environment

Technical Skills

• Proficient in Microsoft Office Suite
• Ability to use clerical and numerical skills in preparing final drafts and documents from raw data
• Ability to create letters, forms, documents, presentations
• Ability to run reports, analyze and interpret data, assist in implementation and maintenance of HR systems

Communication Skills

• Possesses a professional level of written and verbal communication skills
• Ability to communicate complex concept in a clear effective manner3) Possesses excellent cross cultural communication skills and the ability to communicate to staff members at all levels

Physical Demands

Job duties are performed in the typical office environment of the organization, which requires ordinary ambulatory skills sufficient to visit other locations. The environmental factors and/or physical requirements of this position include the following:

• Ability to stand, walk, stoop, kneel, crouch, frequently sit, and lift up to 25 lbs
• Requires good hand-eye coordination, reach with arms & hands, and finger dexterity, including ability to grasp, and manipulate (using keyboard, office equipment)
• Visual acuity to use keyboard, operate office equipment, and read printed material and regularly required to talk and hear