Prior Authorization Representative
Le Mars, IA - USA
Job Summary
Location:
Le Mars IAWorker Type:
RegularWork Shift:
Day Shift (United States of America)Floyd Valley Healthcare is proud to offer a positive and fulfilling work environment that supports a healthy work-life balance. We understand that our employees have choices and we strive to be an employer of choice for our team.
Position Highlights
Come join our award-winning team at Floyd Valley Healthcare as a Centralized Authorization Department Representative.
Floyd Valley Healthcare in Le Mars IA has a full-time Centralized Authorization Representative position (40hours per week). The ideal candidate will have a degree in the medical field (i.e. RN LPN Medical Assistant) and/or medical experience of 2 years with a strong understanding of medical terminology.
Floyd Valley offers a positive culture that supports a healthy work-life balance. Our Mission is to be a progressive healthcare partner serving with compassion integrity and excellence.
Responsibilities:
Determine eligibility for all applicable payors by obtaining prior authorization from insurers for medical tests procedures surgeries and any other prior authorizations required by the patients insurance carrier or Local Coverage Determination (LCD) if needed.
Appropriately document prior authorization and communicate information to performing facility physician clinic staff and patient can/or patients family as necessary.
Utilization of electronic medical record to efficiently process required prior authorizations and communication with in the organization.
Communication with Nurse Manager and/or RN status of denials and appeals. Assist in the coordination of medical records retrieval to support appeal process.
Hours are Monday-Friday 8:00am-4:30pm.
Requirements:
Degree in the medical field and/or 2 years working in a medical environment.
Strong understanding of medical terminology.
Knowledge in ICD-10 and CPT is preferred.
Previous prior authorization and coding experience is preferred.
General computer knowledge is required.
Mandatory Reporter training certificate a plus; certification is required as an employee.
We are proud to offer:
Student Debt Program
IPERS Retirement
Medical Dental and Vision insurance
Flexible Spending Account (FSA)
Short-term and Long-term Disability Insurance
Life Insurance
Fitness Center
Paid Time Off
Competitive pay based on experience
About Floyd Valley Healthcare:
Floyd Valley Healthcare is a 25-bed critical access hospital and is located in Le Mars Iowa home of The Ice Cream Capital of the World! Floyd Valley Healthcare has had a rich history of serving the healthcare needs of people in Le Mars Iowa and the surrounding communities. Today Floyd Valley includes the hospital family medicine clinics in Le Mars Marcus and Remsen and public health. We serve people in their homes through home health and home medical services. Floyd Valley Healthcare is licensed by the State of Iowa affiliated with the Avera System of Sioux Falls South Dakota and is a member of the Iowa and American Hospital Associations.
Pre-employment drug screen background check and employee health review including required immunizations are required. FVH participates in E-Verify.
Floyd Valley Healthcare is an Equal Opportunity Employer committed to providing an environment of opportunities to all applicants and employees without regard to race color religion marital status age national origin physical or mental disability pregnancy gender sexual orientation gender identity or expression veteran status or any other status protected by law.
Required Experience:
Unclear Seniority
About Company
Move your health forward with Avera. Learn about our integrated health system of hospitals, clinics, doctors and community support in South Dakota, Minnesota, Iowa, Nebraska and North Dakota.