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Location: Burlington, MA
Job ID: 176054-1A
Date Posted: Jun 17, 2022
Category: Clinical Support
Welcome to Lahey Hospital & Medical Center, part of Beth Israel Lahey Health. Lahey Hospital & Medical Center is a world-renowned tertiary medical center known for its innovative technology, pioneering medical treatment and leading-edge research. A teaching hospital of Tufts University School of Medicine, the hospital provides quality health care in virtually every specialty and subspecialty, from primary care to cancer diagnosis and treatment to kidney and liver transplantation. It is a national leader in a number of health care areas, including stroke, weight management and lung screenings, among many others. Lahey also helps to advance medicine through research and the education of tomorrow's health care leaders.
About the Job
Position Summary:The Prior Authorization Coordinator is responsible for coordinating comprehensive data elements, insurance verification, and clinical information for prescription pre-authorization management. Maintains knowledge of third party reimbursement regulations and medical terminology. Provides customer support and resolves problems that may arise as a result of customer inquiries. Assures continuity of care for patients receiving services through onsite.
Essential Duties & Responsibilities including but not limited to:
High School Diploma or GED
Licensure, Certification & Registration:
2+ years of clinical experience within a healthcare environment (e.g. hospital, retail, managed care etc.)
Experience in prior authorization submission process
Skills, Knowledge & Abilities:
Knowledge will include, at minimum, prior-authorization workflows, payer relations, prescription claims adjudication, and general reimbursement procedures.
Uses excellent customer service, written and oral communication skills.
Ability to understand and follow specific instructions and procedures;
Superior communication skills
Demonstrated knowledge of insurances perferred
At least one year of pre-cert experience, including navigating websites for online benefit reviews
Excellent clerical, computer, multi-tasking, resource management and phone skills
Skill in the use of personal computers and related software applications.
Creative thinking and problem solving skills, and ability to work well under pressure (most of the paperwork is time sensitive)
Ability to understand importance of and respect for the confidentiality of all patient information in accordance with applicable standards and regulations.
TEAM PLAYER and willing to be diversified
Beth Israel Lahey Health is dedicated to improving health and wellness and making a difference in the lives of our patients, their families and all members of the communities we serve. Formed in March 2019, Beth Israel Lahey Health is a patient-centered, integrated care delivery system providing a continuum of services spanning academic, tertiary and community hospitals, dedicated orthopedic and psychiatric hospitals, primary and specialty care, community acute care, ambulatory care, behavioral services and home health. Beth Israel Lahey Health Performance Network is a unified joint contracting and population health management organization, jointly governed by participating physicians and hospitals.
Equal Opportunity Employer/Minorities/Females/Disabled/Veterans.