The work location for this position is Lewiston, Idaho

This is a PRN position (On-Call - No Benefits) - you will receive an additional 15% PRN pay in lieu of benefits

Hours: 8:00am - 5:00pm

Position Summary:

Assists in coordinating the activities between scheduling, insurance verification, and pre-certification.  Collaborates with a variety of personnel and departments to ensure smooth clinic operations.   

Primary (Essential) Duties:

• Verifies coverage and ensures all insurance requirements are met, as well as obtaining all prior authorization and/or referrals as appropriate prior to patient arrival.
• Works with patients, physicians, charge capture specialists, and third-party representatives as necessary to obtain authorizations.
• May require reviewing insurance company websites for assistance in determining which services require preauth.  Assures precertification is complete by direct call to insurance companies or by checking with physicians? offices.  May recommend re-scheduling of procedures if appropriate, so that pre-admit criteria may be met.
• Obtains initial and subsequent insurance authorization and pre-certification for chemotherapy services, surgeries, outpatient testing, labs, and imaging.
• Handles phone calls from patients regarding prior authorization questions for services ordered/scheduled.
• Maintains a close working relationship with the site Patient Financial Counselor.
• Stays current with insurance requirements.
• Establishes priorities and accomplishes tasks in a timely manner.
• Covers for and assists with other front office functions as requested.
• Performs other duties as assigned.
• Ability to work effectively under pressure with deadlines and exhibit an appropriate sense of urgency
• The above statements reflect the general duties considered necessary to describe the principal functions of the job as identified and shall not be considered as a detailed description of all the work requirements that may be inherent in the position.

Scion Health considers a consistently positive, cooperative, self-motivated, courteous, and professional attitude to be an essential function of every position.  While different positions have different primary areas of responsibility, everyone needs to work as a team, and we expect all employees to roll up their sleeves and pitch in as necessary to get the job done.

Employees must be able to relate to other people beyond giving and receiving instructions: (a) can get along with co-workers or peers without exhibiting behavioral extremes, (b) perform work activities requiring negotiating, instructing, supervising, persuading, or speaking with others; and (c) respond appropriately to constructive feedback from a supervisor.

While this job description is intended to be an accurate reflection of the requirements of the job, management reserves the right to add or remove duties from particular jobs when circumstances (e.g., emergencies, changes in workload, rush jobs or technological developments) dictate.

• High school graduate or equivalent
• Knowledge of insurance  
• Demonstrated clerical skills required, preferably in a medical setting. 
• Completion of a Medical Secretary program may be substituted for experience.   
• Must possess good oral and written communication skills
• Knowledge of medical terminology
• Type 45 wpm accurately
• Be able to make simple math calculations
• Must be able to read and comprehend complex written material, operate office equipment including computer terminals, and observe rules of confidentiality. 
• Must become thoroughly familiar with specific hospital policies and procedures for admission and outpatient registration and with Medicare, Medicaid, and insurance pre-admission requirements and criteria. 
• Must become familiar with various insurance benefit plans, billing requirements, and hospital credit/collection policies.

About St. Joseph Regional Medical Center

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