Prior Authorization Representative

Location:

Le Mars, IA

Worker Type:

Regular

Work Shift:

Day Shift (United States of America)

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 (40 hours 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 patient’s 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 patient’s 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.