Pre Auth Financial Specialist - Admitting bei Ivinson Memorial Hospital

At Ivinson Memorial Hospital we are committed to excellence, trust, healing, and integrity.  We pride ourselves in providing compassionate, world-class care to our community. At Ivinson we offer a competitive total rewards package including; full medical, dental, and vision insurance, retirement plans, paid time off and tuition reimbursement opportunities. Ivinson aims to improve the care provided for our patients and create a work-life balance for our employees by creating a culture of transparency, teamwork, accountability, and trust.

Base salary starts at $17.30/hr.

E S S E N T I A L  F U N C T I O N S

•  Compiles and communicates accurate and pertinent clinical data and demographics to the patient’s insurance company.
•  Keeps current on insurance regulations to obtain and record patient data; and maintain knowledge of system requirements.
•  Follow-up with insurance carriers to obtain certification/authorization numbers for outpatient services.
•  Performs on-line data entry of certification/authorization or denials and pre-authorization status.
•  Facilitates resolution of pre-authorization or referral issues for scheduled patients and same day add-ons to insure payment from the insurance company on the patient’s behalf.
•  Works closely with Utilization Review to ensure all notifications, prior authorizations and continued stay reviews are completed as needed.
•  Coordinates with Social Worker when needed.
• Ensures that all prior authorizations and ongoing authorizations documentation, databases, and records are maintained clearly and accurately, within a timely manner and meet HIPPAA requirements.
• Coordinates peer to peer reviews with providers for denied requests.
• Perform clinical reviews of authorization requests using appropriate criteria.
•  Serves as a resource for staff, APP’s and physicians regarding prior authorizations.
•  Collaborates with clinical staff to resolve any problematic authorization issues.
•  Creates payment arrangement forms for uninsured patients and effectively communicates payment requirements to patients.
•  Ensures mail is documented and filed for all patient authorizations.
•  Performs other duties as assigned.
• Demonstrates consistent use of AIDET (Acknowledge patient, Introduce yourself, provide duration/timeline for test, Explain the process & Thank them for choosing IMH) and HEAL (Hear them out, Empathize, Apologize, & Leap into action to solve) when interacting with patients/customers).
• Collaborates with all departmental staff to facilitate timely patient care.
• Participates in performance improvement activities.
• Attends/participates in staff meetings, in-services, & facility wide meetings as scheduled.

E D U C A T I O N

•  High school diploma or equivalent required.
•  Clinical experienced preferred as a CNA, Medical Assistant, Patient Care Technician or Billing coder etc.

E X P E R I E N C E

•  Clinical experience preferred.
•  Previous experience in insurance verification preferred.

C R E D E N T I A L S

• Must have current, valid Basic Life Support (BLS) certification or must obtain within 6 months of hire and maintain credentials throughout employment with IMH.

K N O W L E D G E , S K I L L S  A N D  A B I L I T I E S

•  Excellent customer service skills, including but not limited to: a friendly personality, tact, patience, empathy and a helpful, professional attitude both in person and on the telephone.
•  Ability to effectively communicate with staff, managers and the general public verbally and in writing.
•  Demonstrate effective listening skills.
•  Excellent organization and time management skills and ability to establish priorities effectively.
•  Possess exceptional problem solving skills.
•  Ability to work effectively without immediate supervision.
•  Ability to learn new computer software programs.
•  Ability to recognize and protect confidential information.
•  Demonstrate ethical and legal accountability for the position.

At Ivinson Memorial Hospital, we believe that our employees are our greatest investment. That’s why we are committed to fostering a supportive, empowering environment where every team member has the resources and opportunities to thrive. We know that providing world-class healthcare starts with investing in our employees, ensuring they have the tools to grow, excel, and provide exceptional care.   

Our competitive and comprehensive total rewards package includes: 

For benefits eligible employees:     

• Medical, dental, and vision insurance
• Paid time off: take the time you need to recharge
• Retirement plans, including 403(b) matching
• Employer-paid life and long-term disability insurance: Peace of mind for you and your family

For all employees:     

• Yearly work anniversary pay increases
• Education Reimbursement; up to $2,500 annually
• Retirement plan participation
• Free certification classes: enhance your skills at no cost to you
• Health and Wellness discounts at local gyms
• Discounts at select mobile networks, local vendors, and Elitch Gardens
• Mental Health: 6 free confidential, in-person counseling sessions offered by Pathways annually
• Financial Counseling: free services through WellCents to help you take control of your financial journey
• Legal assistance and will preparation services
• Student Loan Forgiveness: Ivinson Memorial Hospital is a qualifying employer for the federal Public Service Loan Forgiveness (PSLF) program

Please use this link for more information regarding our rewards package and benefits: Benefits Guide.

At Ivinson Memorial Hospital, we are more than just a workplace – we are a community where your growth and well-being matter. Join us in making a difference in the lives of the Laramie community and help us provide world-class care.