Idaho Falls Community Hospital is looking for a Imaging Pre-Authorization/Denial and Scheduler Insurance Specialist to join our team!

JOB SUMMARY: Verifies insurance eligibility and obtains pre-authorization for diagnostic tests and procedures. Works closely and communicates with referring providers and imaging scheduling team to authorize and process requests timely. Investigates and assists with insurance denials. Schedules patient imaging and cardiology exams for referring practices.

BENEFITS:

Taking care for our community starts with taking care of our own team. Idaho Falls Community Hospital is proud to offer its employees competitive and comprehensive benefit packages. Benefits include:

• Medical, Dental and Vision Insurance
• Paid Time Off (vacation, holidays and sick days) and Medical Paid Time Off
• Retirement Plans (401K with up to 6% match)
• Earned Quarterly Bonus Program
• Education Reimbursement Program
• Discount for medically necessary procedures performed at Idaho Falls Community Hospital and Mountain View Hospital

Please note benefits are based on eligibility according to full-time, part-time or PRN status classification.

DUTIES AND RESPONSIBILITIES:

Imaging Pre-Authorization/Denial Insurance Specialist:

• 
  Responsible for verifying eligibility and obtaining preauthorization for diagnostic tests and procedures.
• Works with the referring providers to make sure we receive all the patient demographics, order that meets requirements, and other necessary documentation needed to obtain an authorization.
• Insures authorizations are done timely and communicates with referring provider office, imaging schedulers and patient when delays or insurance issues arise to ensure continuity of care.
• Knows and understands the difference between routine and emergent authorization requests and when to use them.
• Communicates with worker’s compensation and VA Administrations to obtain approval for services.
• Assists with insurance denials and the appeal process. Helpful in researching patient accounts for insurance payment issues.
• Secures physician orders and uses all patient information for charting, billing and record keeping purposes.
• Review patient insurance coverage and billing determination for procedures with CMS and insurers. Validate pre authorizations prior to exam and procedures.

ABOUT IDAHO FALLS COMMUNITY HOSPITAL:

At Idaho Falls Community Hospital, helping our community get better is our number one priority. We are committed to providing compassionate, emergency care 24 hours a day, 365 days a year. Idaho Falls Community Hospital is proud to have a state-of-the-art Emergency Department, a stroke and diagnostic cardiac center, and a trauma center.

Our work environment is collaborative, purpose driven and people centric. Our culture is unique and it is what makes people excited to come to work each day. If you are looking for a career where you can make a difference, we have a place for you on our team.

• High school diploma or general education degree (GED).
• Must have 1-5 years medical terminology experience. Experience with medical insurance is required.
• Ability to use hospital information system, and operate basic computer functions and software.
• Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Employee must possess the ability to speak effectively, before groups of customers and or employees of the organization. Good telephone skills are a must.
• Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
• Ability to apply common sense to carry out instructions furnished in written, oral, or diagram form. Employee must possess the ability to deal with problems involving several concrete variables in standardized situations.