Insurance Authorization Specialist

About Steward Health Care
Nearly a decade ago, Steward Health Care System emerged as a different kind of health care company designed to usher in a new era of wellness. One that provides our patients better, more proactive care at a sustainable cost, our providers unrivaled coordination of care, and our communities greater prosperity and stability.
As the country’s largest physician-led, tax paying, integrated health care system, our doctors can be certain that we share their interests and those of their patients. Together we are on a mission to revolutionize the way health care is delivered - creating healthier lives, thriving communities and a better world.
Steward is among the nation’s largest and most successful accountable care organizations (ACO), with more than 5,500 providers and 43,000 health care professionals who care for 12.3 million patients a year through a closely integrated network of hospitals, multispecialty medical groups, urgent care centers, skilled nursing facilities and behavioral health centers.
Based in Dallas, Steward currently operates 39 hospitals across Arizona, Arkansas, Florida, Louisiana, Massachusetts, Ohio, Pennsylvania, Texas, and Utah.
For more information, visit www.steward.org.

At Sharon Regional Medical Center, we are committed to improving the health of our communities by delivering exceptional, personalized health care with dignity, compassion and respect. Our Continued focus on the patient experience informs our caregivers in how to provide care that is respectful of and responsive to individual patient and family preferences, needs and values.

We dedicate ourselves in the communities we serve to delivering affordable health care to all and being responsible partners. No matter what your role, as a member of the Steward family, you are a specialist in the making every patient and family feel right at home, every co-worker a key to our success, and every referring practice, a team of prized colleagues.

In support of this, we commit ourselves to the following values:

Compassion

Accountability

Respect

Excellence

Stewardship

If you are seeking a fast-paced, challenging position in an organization committed to achieving and maintaining a standard of excellence in all we do, our organization may be a good fit for you.

Job Summary:

Authorization team is responsible for conducting financial analytics into a patient's overall financial responsibility as it relates to upcoming care within the Steward Healthcare System. Analysis payer contracts as well as state and federal regulatory guidelines to maximize revenue realization. This individual will supervise incoming patient orders and collect information needed to complete authorization for the scheduled procedures. These efforts will result in improving patient collections and decrease denials. Interactions will primarily be conducted with insurance companies, physician and patients, via phone, email or payer websites. Authorization team members to be proficient in Windows, Microsoft Office, and Excl, Meditech, and Athena.

Customer Service: Communicate in a manner consistent with positive patient, departments and physician office relations. Provide helpful assistance in anticipating and responding to the needs of all patients, families, departments and physician offices. Collaborate with customers in planning and decision-making to result in optimal solutions. Remain calm under pressure and effectively deal with difficult people. Independently recognize, interpret, and evaluate situations and their level of urgency.

Other duties: Counsel patients on prior authorization, referral requirements, and insurance networks as prompted by electronic insurance correspondence. Evaluate referrals and link to appropriate upcoming appointments. Submit online requests for prior authorization to be completed by Prior Authorization department. Track and manage the request through to appointment resolution. Counsel patients on financial responsibility form if referral is not obtained by time of service.

Requirements:

• High School Diploma or Equivalent
• Associates Degree (preferred)
• Background Clearances (as required by law)
• Strong Customer Service Skills
• Strong Attention to Detail

Benefits:

• Medical
• Dental
• Vision
• 401K
• Vacation time
• Sick time

Please note, our Sharon Regional Medical Center is taking additional, necessary preparations to ensure patients can receive compassionate care in a safe, carefully managed environment - with confidence and without fear. Our Safe and Ready program consists of a rigorous [five-point] standard ensuring patient safety, confidence, and convenience: Expanded hours will allow previously canceled procedures to be scheduled as quickly as possible. Any COVID-19 related care takes place in designated areas away from other patients and their families. Emergency Departments are reorganized to be a safe place to treat all emergency patients. A stringent cleaning policy is required for patient safety. You can rest assured that we have made the necessary preparations to provide care in a safe, controlled, and professional way.

Steward Health Care is proud to be a minority, physician owned organization. Diversity, equity, inclusion and belonging are at the foundation of the care we provide, the community services we support and all our employment practices. We do not discriminate on the grounds of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, and or expression or any other non-job-related characteristic.