Shire Jobs

TITLE

Prior Authorization Specialist

FULL-TIME/PART-TIME

Full-Time

EXEMPT/NON-EXEMPT

Non-Exempt

DESCRIPTION

PURPOSE:The Prior Authorization Specialist (PAS) is an essential role responsible for facilitating exceptional patient experience, by securing authorizations for all scheduled services.

JOB SUMMARY: The Prior Authorization Specialist is responsible for obtaining and verifying prior authorizations from insurance payers for medical health services.Prior to a patient's treatment, the Prior Authorization Specialist reviews patient insurance and clinical documents and contacts payers to receive prior authorization from the insurance payer. Authorization Specialists are responsible for verifying the treatment is authorized and verifying that required payer documentation and authorization records are on file.

Named one of theBest Places to Work in Northern Nevadain 2015, 2018, and 2019we offer a great deal of attention to ensuring our employees havework/life balanceand theopportunity to grow and develop their careers. We offer asecond-to-none benefits package(where there are free options for employee health, vision, dental and basic life insurance for full-time employees), very competitive compensation, generous paid time off, and a chance to partner with amazing care providers to changes lives.Check out our AMAZING benefits program athttps://www.nnhopes.org/wp-content/uploads/2023/12/HOPES-Benefits-Overview-23-24.pdf.

At HOPES, all employees serve as ambassadors to our patients and the community. Your co-workers at HOPES are one of the many contributing factors to HOPES being named one of Northern Nevada's Best Places to Work three times in the last five years. To learn more about the Key Accountabilities of HOPES Squad members, take a look athttps://www.nnhopes.org/wp-content/uploads/2020/03/HOPES-Squad-KAAs.pdf.

Fit is as important as function at HOPES. We enjoy a VERY special collaborative culture that thrives on open communication and valuing everyone's contribution to the team. We are as unique as the populations we serve! However, we all agree on our dedication to optimizing wellness for the people we serve and understand we ALL are responsible for the mission of Northern Nevada HOPES.

To find out more about HOPES, visit our website athttps://www.nnhopes.org/. We have a great mission and have been inducted into theBest Places to Work Hall of Fame. All our careers are listed on our Careers pageathttps://www.nnhopes.org/about/careers/. If you'd like to learn more about what HOPES is doing in the community, sign up for our newsletter.athttps://www.nnhopes.org/newsletter/.

Northern Nevada HOPES is a Federally Qualified Health Center and Patient Centered Medical Home.

We are a Drug-Free Workplace and utilize E-Verify to confirmwork eligibility.

POSITION REQUIREMENTS

• High school diploma or General Education Development (GED) equivalent required

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``` - Valid BLS required prior to hire, per HRSA compliance. - Knowledge and/or work experience related to Behavioral Health/Mental Health third-party payers, copays, deductibles, and authorizations. - Strong ability to navigate and research information on payer websites and payer documentation and speak with payer representatives over the phone. - Experience working with insurance payers and obtaining prior authorizations. - Strong computer skills, including Microsoft Office/Outlook /Word/Excel skills. - Ability to learn new software quickly. - Knowledge of Medical terminology and process - Extremely Detail oriented. - Ability to work on short deadlines. - Ability to Multi-task - Strong time management and organizational skills

EOE STATEMENT

Northern Nevada HOPES is an Equal Opportunity Employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination on the basis of race, color, religion, sex (including pregnancy, gender identity or expression, and sexual orientation), parental status, national origin, age, physical or mental disability, genetic information or veteran status in all employment practices.

SALARY RANGE

$20 - $22.20