PATIENT PROCESSING PRIOR AUTHORIZATION SPEC- PINNACLE CARDIO

EAMC MISSION

At East Alabama Medical Center, our mission is high quality, compassionate health care, and that statement guides everything we do. We set high standards for customer service, quality, and keeping costs under control.

POSITION SUMMARY

The PPS authorization specialist is responsible for ensuring an efficient, accurate, and complete pre-registration and/or authorization process for patients within East Alabama. This role involves verifying patient demographic and insurance information, obtaining timely insurance authorizations, pre-certifications, and referrals for scheduled and emergent services, and confirming insurance coverage prior to services being rendered. The specialist serves as a liaison between patients, providers, and insurance carriers to secure required approvals, explain benefits and out-of-pocket responsibilities, and ensure compliance with payer requirements. This position plays a critical role in preventing claim denials, supporting financial transparency for patients, and promoting the delivery of uninterrupted, high-quality patient care.

POSITION QUALIFICATIONS

Minimum Education High School Diploma or equivalent Minimum Experience 1-2 years customer service experience Required Registration/License/Certification N/A Preferred Education Associate Degree in Business or Health related field, Knowledge of Medical Terminology Preferred, Knowledge of ICD-10 and CPT coding preferred Preferred Experience 1-2 years healthcare/hospital experience and/or customer service experience. 1-year computer experience and the ability to type and spell accurately. Insurance verification and authorization experience Preferred Registration/License/Certification N/A Other Requirements N/A