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Administrative
Enrollment / Eligibility Specialist
Plymouth, NH
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Admissions and Authorization Specialist
Legal Address - Plymouth, NH 03264
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Overview
Position Type
Full Time
Job Shift
Days
Description
Job Title:
Admissions & Authorization Specialist
We're seeking a detail-oriented and efficient Admissions & Authorization Specialist to join our Patient Access team. In this role, you'll play a crucial part in facilitating financial reimbursement and minimizing the organization's financial risk. Your work will directly support our mission by helping us operate efficiently and sustainably.
About Speare Memorial Hospital
Speare Memorial Hospital is a 25-bed critical access hospital serving dozens of communities in the Lakes Region. We are passionately committed to providing exceptional, local care to our friends, families, neighbors, and communities at large.
Mission:
To work together to serve the needs of our patients and community.
Vision:
A community where all can achieve optimal health.
Values:
Kindness, Collaboration, Patient & Family-Centered, Safety, Excellence, Efficiency, and Professionalism.
What You'll Do:
Authorization & NOA Responsibilities:
Review scheduled services to determine authorization requirements based on payer guidelines
Submit timely Notice of Admission (NOA) to CMS and private payers within the required 24-48 hour regulatory window to avoid reimbursement penalties
Initiate and complete prior authorizations via payer portals, phone, or fax
Obtain and verify required clinical documentation to support medical necessity for both authorization forms and NOA submissions
Track and follow up on authorization and NOA status to prevent delays, denials, or "untimely filing" reductions
Communicate authorization outcomes and NOA-related issues to clinical and billing departments
Patient Access/Registrar Backup Responsibilities:
Greet and direct patients and visitors appropriately
Register patients for hospital services
Verify demographic and insurance information
Perform real-time insurance eligibility verification
Obtain required patient signatures and provide "Important Message from Medicare" (IM) or "Notice of Medicare Non-Coverage" (NOMNC) where applicable
General Responsibilities
Maintain patient confidentiality and HIPAA compliance
Participate in training and continuing education
Support revenue cycle process improvements
Demonstrate strong customer service and professionalism
What We're Looking For:
Required:
High School Diploma
1-2 years healthcare experience required
Knowledge of insurance authorization workflows
Attention to detail and accuracy
Strong communication and organizational skills
Ability to multitask in a fast-paced environment
Proficiency in EMR systems and payer portals
Ability to work independently and escalate appropriately
Preferred:
Associate's Degree
Prior authorization Notice of Admission filing, and Meditech experience highly preferred
Why Join Speare Memorial Hospital?
Community Connection:
Be part of an organization deeply invested in local health and wellness.
Collaborative Culture:
Work alongside dedicated professionals who genuinely care about their work and each other.
Professional Growth:
Opportunities for continuing education and career development.
Comprehensive Benefits:
Competitive salary
Health, dental and vision insurance
Health savings accounts with employer contributions
403(b) retirement plans with generous employer contributions
Lifestyle Savings Account reimbursement program
Tuition Assistance and Student Loan Repayment programs
Employee recognition and appreciation programs
Generous Earned Time accrual
Short-Term & Long-Term Disability
Life insurance
Our Commitment
Speare Memorial Hospital is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We believe that a diverse workforce strengthens our ability to serve our equally diverse community.
Join us in our mission to provide compassionate, high-quality healthcare to our community.