Clinical Authorization Specialist LPN

Ruby Memorial Hospital (wvuh)mid

OtherAuthorization Specialist

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Quick Summary

Key Responsibilities

The statements described here are intended to describe the general nature of work being performed by people assigned to this position.

Requirements Summary

EDUCATION, CERTIFICATION, AND/OR LICENSURE:1. High school graduate or equivalent.2.

Technical Tools

OtherAuthorization Specialist

About the Role

~1 min read

Support the authorization department through utilization of clinical knowledge with associated treatments. Provides analysis of medical records to determine medical necessity in the clinical record and provides feedback to the providers and clinical team. Navigates high dollar treatments and provides additional clinical support as well as potential patient contact.

Responsibilities

~1 min read

1. Excellent oral and written communication skills.
2. Excellent customer service and telephone etiquette.
3. Must demonstrate the ability to use tact and diplomacy in dealing with others.
4. Knowledge of ICD9/CPT Coding or Medical Terminology.
5. Knowledge of third party reimbursement.

United States of America (Non-Exempt)

403 WVUH Care Management

West Virginia University Health System and its subsidiaries (collectively "WVUHS") is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. WVUHS strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. All WVUHS employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.