Pre Auth Financial Specialist - Admitting

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.