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Posted: 21-Feb-25
Location: Saint Louis, Missouri
Categories:
Internal Number: 86442
BJC is looking to add a new Prior Authorization Rep to their Team!
Additional Preferred Requirements
- Remote Monday - Friday
- 8-4:30 PM
- No weekends but some Holidays
- Preferred experience - EPIC, Insurance verification, Prior Authorization experience- preferably in Pharmacy
Overview
Barnes-Jewish Hospital at Washington University Medical Center is the largest hospital in Missouri and is ranked as one of the nation's top hospitals by U.S. News & World Report. Barnes-Jewish Hospital's staff is composed of full-time academic faculty and community physicians of Washington University School of Medicine, supported by a house staff of residents, interns, fellows and other medical professionals. Recognizing its excellence in nursing care, Barnes-Jewish Hospital was the first adult hospital in Missouri to be certified as a Magnet Hospital by the American Nurses Credentialing Center.
The Alvin J. Siteman Cancer Center¿at Barnes-Jewish Hospital and Washington University School of Medicine¿is an international leader in cancer treatment, research, prevention, education and community outreach. It is the only cancer center in Missouri and within a 240-mile radius of St. Louis to hold the prestigious Comprehensive Cancer Center designation from the National Cancer Institute and membership in the National Comprehensive Cancer Network. Parent institutions Barnes-Jewish Hospital and Washington University School of Medicine also are nationally recognized, with U.S. News & World Report consistently ranking the hospital and medical school among the nation's elite. This department includes the nurse manager, nurse practitioner, one LPN, and a group of nurse coordinators who work together to accomplish coordination of patient care with multiple other departments and the infusion center. The nurse coordinators work hand in hand with their physician and patient/family to ensure appropriate care is coordinated before, during, and after their treatment. Job functions include scheduling of appointments and treatments, telephone triage, patient and family education, and numerous other responsibilities.
Preferred Qualifications
Role Purpose
This role is critical in the financial clearance process which assists BJC hospitals enterprise wide in securing the appropriate authorization and/or Notice Of Admission (NOA) in order to pevent rescheduling the patient or risking net revenue loss. This position is required to obtain authorization on behalf of some physicians at Washington U school of medicine and BJC medical group and must maintain positive relationships. This position ensures the technology is built in a way to accurately support the scripting and validation of authorization and NOA. Without the above we are limited in our collection of payment. The role represent BJC with the highest standard of customer service, compassion and perform all duties in a manner consistent with our mission, vision, values, and service standards. Facilitates certain components of the patients' entrance into any BJC facility, including insurance validation, benefit verification, pre-certification & financial clearance. Responsible for ensuring that the most accurate patient data is obtained and populated into the patient record, particularly authorization data and status. This team member must possess exceptional attention to detail & maintain knowledge & competence with insurance carriers, Medicare guidelines & federal, state & accreditation agencies.
Responsibilities
Minimum Requirements
Education
Experience
Preferred Requirements
Education
Experience
Licenses & Certifications
Benefits and Legal Statement
BJC Total Rewards
At BJC we’re committed to providing you and your family with benefits and resources to help you manage your physical, emotional, social and financial well-being.
- Comprehensive medical, dental, vison, life insurance, and legal services available first day of the month after hire date
- Disability insurance* paid for by BJC
- Pension Plan*/403(b) Plan funded by BJC
- 401(k) plan with BJC match
- Tuition Assistance available on first day
- BJC Institute for Learning and Development
- Health Care and Dependent Care Flexible Spending Accounts
- Paid Time Off benefit combines vacation, sick days, holidays and personal time
- Adoption assistance
To learn more, go to www.bjctotalrewards.com/Benefits
*Not all benefits apply to all jobs
The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job. Equal Opportunity Employer