Position Purpose
This position is responsible for supervising the Insurance & Authorization Specialist team, ensuring appropriate and accurate submission of insurance prior authorization requests. The scope of the position involves leadership in interpreting insurance coverage, understanding outpatient hospital insurance benefits and reviewing clinical documentation for prior authorization submission.
What you will do
Complete insurance eligibility verification to determine the benefits and coverage for patients
Communicate benefit concerns and/or questions to Centralized Financial Clearance Unit representative staff, physician or financial counselor for follow up with patient
Assist patients with billing related inquiries if necessary
Review financial/insurance information obtained to meet State, Federal and Third Party billing requirements to ensure reimbursement for services
Satisfy admission notice requirements for pre-certification/authorization for HMO/commercial payers
Editing, updating and timely filing of all new information gathered for each admission
Minimum Qualifications
High School Graduate or equivalent, college experienced preferred
5 years Patient Accounting and/or Financial Counseling. Knowledge of billing regulations helpful.
Knowledge of medical terminology and medical insurances.
Position Highlights and Benefits
Full time 40hrs M-F days
Excellent benefits - starting day 1!
Ministry/Facility Information
Saint Francis Hospital is committed to exceeding the expectations of our patients and families by providing world-class service in a progressive, people-centered, compassionate health care environment. We are licensed for 617 beds and 65 bassinets, are a major teaching hospital and the largest Catholic hospital in New England.
Our Commitment to Diversity and Inclusion
Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.