Position Purpose
This position is responsible for reviewing financial/insurance information obtained to meet State, Federal and Third-Party billing requirements to ensure reimbursement for services.
What you will do
Responsible for authorization and denials within Case Management ensuring appropriate authorization for inpatient hospital admissions
Assists in the identification, reporting and resolution of any issues stemming from or with authorization and denial processes
Supports the needs of the Case Management Utilization Coordinator team using data, system reports, and analytics
Develops and Implements strategies to optimize all aspects of authorization and denials supporting hospital revenue integrity team through a comprehensive approach
Minimum Qualifications
Associate degree and 1–2 years of healthcare experience required, or, in lieu of an Associate degree, a high school diploma/GED and 5 or more years of healthcare experience will be considered
Medical billing or insurance authorization experience preferred
Excellent customer service skills and the ability to communicate professionally required
Position Highlights and Benefits
Full time 40-hour week - includes every other weekend and rotating Holidays. Pay Differentials will apply!
Position is on site, local residency required
Great benefits and Health Insurance Coverage - Day 1
Ministry/Facility Information
Saint Francis Hospital is committed to exceeding the expectations of our patients and families by providing world-class service in a progressive, people-centered, compassionate health care environment. We are licensed for 617 beds and 65 bassinets, are a major teaching hospital and the largest Catholic hospital in New England.
Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.