Description
Professional - Nonclinical
Req #: 30124
($3,000.00 Sign on Bonus paid in 3 installments, prorated for Part Time)
Current MaineHealth employees not eligible for the sign on bonus. Must be separated from MaineHealth system for 6 months to be eligible.
Summary
Responsible for assisting patients and providers with the pre-authorization of medications, as required by patient’s insurance plan. Verifies insurance eligibility and benefits. Documents information obtained from insurances and communicates with insurances, patients and clinical staff following appropriate protocols and workflows in the EMR. Responsible for ensuring that all medication pre-authorization requests are processed in an accurate and timely manner for continuity of patient care. Collaborates and communicates regularly with clinical departments to ensure efficiency in authorization processes. The Prior Authorization Specialist has an expertise in obtaining and maintaining pre-authorizations from insurance companies, allowing patients to quickly access the important treatment they need. This is a hybrid role that allows working remotely with the ability to come in-office for training and as needed.
Required Minimum Knowledge, Skills, and Abilities (KSAs)
Education: High school diploma or GED preferred.- License/Certifications: N/A
- Experience: Experience as a medical assistant, pharmacy technician, or prior authorization work in healthcare or related environment required.
- Additional Skills/Requirements Required: N/A
- Additional Skills/Requirements Preferred: Medical Terminology. Knowledge of Medical Insurance and concept of referrals/pre-authorizations.
Additional Information
With a career at any of the MaineHealth locations across Maine and New Hampshire, you’ll be working with health care professionals that truly value the people around them – both within the walls of the organization and the communities that surround it.
We offer benefits that support an individual's needs for today and flexibility to plan for tomorrow – programs such as paid parental leave, a flexible work policy, student loan assistance, training and education, along with well-being resources for you and your family.
MaineHealth remains focused on investing in our care team and developing an inclusive environment where you can thrive and feel supported to realize your full potential. If you’re looking to build a career in a place where people help one another deliver best-in-class care, apply today.
If you have questions about this role, please contact Todd R. Nevins at todd.nevins@mainehealth.org