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Visit us online at:

https://www.aikenregional.com

Position Description:

The Pre-Authorization Specialist is responsible for identifying prior authorization requirements by insurance /payer, processes, and obtains prior authorizations for scheduled and add on services. Determines if services are a covered benefit, obtains pre-authorization and documents information in CERNER. Communicates with the ordering Provider's office if services were approved or denied and facilitates peer-to-peer reviews when needed to prevent denials and improve Physician satisfaction.

Duties:

Locates, reviews and obtains appropriate chart documentation from all sources (Physician, CERNER, etc.) based on payer requirements needed to obtain prior authorization for scheduled/ add-on IP and OP procedures/admissions/surgeries. Communicates with physician office regarding status of authorization, information needed, facilitates, and completes peer-to-peer reviews when needed. Initiate appeals for denied authorizations prior to service rendered avoiding denials and/or penalties to the facility. Understands Insurance processing requirements i.e.; (verification, authorization, terms, requirements and regulations) and familiar with payer processes to obtain authorization in a timely manner. Benefit Highlights Unlimited Employee Referral Bonus Program Competitive Compensation & Generous Paid Time Off Excellent Medical, Dental, Vision and Prescription Drug Plans Tuition/Certification Reimbursement after 6 months Culture of Excellence - Employee Recognition program Challenging and rewarding work environment Clinical Nursing Ladder opportunities SoFi student loan refinancing program 401(K) with company match and discounted stock plan Career development opportunities within UHS and its 300+ Subsidiaries! More information is available on our

Benefits Guest Website:

uhsguest.com About Universal Health Services One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (

NYSE:

UHS) has built an impressive record of achievement and performance, growing since its inception into a Fortune 500 corporation. Headquartered in King of Prussia, PA, UHS has 99,000 employees. Through its subsidiaries, UHS operates 28 acute care hospitals, 331 behavioral health facilities, 60 outpatient and other facilities in 39 U.S. States, Washington, D.C., Puerto Rico and the United Kingdom.

Qualifications Requirements:

Qualifications:

Requirements:

Associate degree in business or related major preferred and/or 5 years or more of directly related experience performing same or similar job function. CHAA - (Certified Healthcare Access Associate) certification preferred. Five (5) years' experience in a health care facility or equivalent position performing same or similar job duties required. Medical Terminology completion preferred, understanding of third-party payer requirements (Authorization, verification and regulations). Ability to receive and express detailed information through oral and written communication. EEO Statement All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. 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Find & Apply For Enrollment / Eligibility Specialist Jobs in Aiken, South Carolina

Pre-Authorization Representative

Enrollment Services Specialist (4EM26)