Full-Time Authorization & Eligibility Representative

Join Ashe Memorial Hospital – Ashe’s Best Place to Work!

At Ashe Memorial Hospital, we are driven by our mission:
“To meet the needs of the community by delivering patient-centered, high quality health care.”

Ashe Memorial Hospital is proud to have been voted Ashe’s Best Place to Work in 2022, 2023, 2024, and 2025. Join a team recognized throughout the community for excellence in healthcare, including awards for Best Hospital, Best Surgeon, Best Physician, Best Nurse, and Best Medical Practice. This is your opportunity to make a meaningful difference in a close-knit mountain community.

Why You’ll Love It Here:

• 1st shift, Monday–Friday | No nights or travel
• Pay commensurate with experience
• Benefits start the 1st of the month following employment
• Work for Ashe’s Best Hospital, Best Surgeon, and Best Medical Practice
  

What You’ll Do:

1. Utilizes work list to contact appropriate utilization management company or insurance payer to request
   authorization where company can obtain.
2. Sends timely requests to referring physicians for authorization numbers where company cannot obtain.
   Communicates authorization cases denied for medical necessity or requiring peer to peer review to the
   referring physician for resolution.
3. Validates all authorizations for accuracy prior to exam.
4. Follows up on all pending authorizations with the appropriate entity. Forward correspondence to offices
   for exams on their daily schedule.
5. Documents authorization in scheduling system according to defined protocol.
6. Answers incoming calls from offices, referring physicians and patients
   requirements and status.
7. regarding authorization
8. Answers incoming calls from patients to provide an estimate of our of pocket cost after insurance
   processing prior to exam.
9. Arranges appropriate date/time based on patient needs and exam being scheduled when patient calling
   for price quote elects to have procedure performed.
10. Responsible for contacting patients directly to reschedule the exam if authorization is not obtained prior
    to appointment time.
11. Executes eligibility searches using available applications.
12. Researches eligibility exceptions to locate missing information or determine if there is an absence of
    coverage.
13. Provides excellent customer service with all customers.
14. Adheres to referring physician requested protocol regarding authorization requests.

What We’re Looking For:

• High school diploma or GED
• 1+ year healthcare experience preferred; insurance authorization experience a plus
• Strong communication and organizational skills
• Fully vaccinated for COVID-19 and other required immunizations.

How to Apply:

Submit your application, resume, and cover letter, including any employment gaps and reasons for separation. Criminal background check and drug screen required.