ARKANSAS CHILDREN'S IS A TOBACCO FREE WORKPLACE. FLU VACCINES ARE REQUIRED. ARKANSAS CHILDREN'S IS AN EQUAL OPPORTUNITY EMPLOYER. ALL QUALIFIED APPLICANTS WILL RECEIVE CONSIDERATION FOR EMPLOYMENT WITHOUT REGARD TO RACE, COLOR, RELIGION, SEX, SEXUAL ORIENTATION, GENDER IDENTITY OR EXPRESSION, NATIONAL ORIGIN, AGE, DISABILITY, PROTECTED VETERAN STATUS OR ANY OTHER CHARACTERISTIC PROTECTED BY FEDERAL, STATE, OR LOCAL LAWS.
This position has been designated as safety sensitive and cannot be filled by a candidate who is a current user of medical marijuana.
CURRENT EMPLOYEES: Please apply via the internal career site by logging into your Workday Account (https://www.myworkday.com/archildrens/)and search the "Find Jobs" report.
Work Shift:
Day Shift
Time Type:
Full time
Department:
CC017115 Outpatient Prior AuthorizationsResponsible for the pre-verification of insurance for patients being admitted into the hospital for care. Ensures insurance coverage, resolves any issues with coverage and escalates complicated issues. Verifies, interprets, coordinates, disseminates insurance information; establishes and counsels patient on co-payments, maintains charge capture information.
Salary:
Most new hires start between $16.30-$20.30 per hour, depending on experience and qualifications.
Responsible for the pre-verification of insurance for patients being admitted into the hospital for care. Ensures insurance coverage, resolves any issues with coverage and escalates complicated issues. Verifies, interprets, coordinates, disseminates insurance information; establishes and counsels patient on co-payments, maintains charge capture information.
No education requirements
High school diploma or GED or equivalent
Entry Level - Experience not Required.
1. Obtains pre-authorization approvals for outpatient procedures from the Surgery, Day Medicine, Radiology, Nuclear Medicine, Genetics, Sleep lab and Heart Station departments.
2. Preregisters, obtains prior authorization, price estimates, PCP referrals, upfront collections and referred accounts prior to date of service.
3. Obtains prior authorizations and insurance verification for all clinics, Medicare patients, out-of-state Medicaid, SDC and for specialty drugs.
4. Obtains the appropriate prior authorizations for surgical and outpatient procedures and the necessary CPT/ICD-10 diagnosis codes when appropriate.
5.Obtains price estimates, upfront collections and referred accounts prior to date of service.
6.Completes outbound calls to families regarding insurance coverage and benefits, high deductibles, co-pays, denials.
7. Conducts appropriate follow-ups and verifications on all assigned accounts including documenting in the patients account detailed insurance information prior to services being rendered.
8. Ensures that pre-certifications, pre-notifications, prior authorizations or referrals are received for each account with a financial class of insurance and/or Medicaid.
9. Appropriately refers all high dollar or self-pay accounts to Financial Counselor.
10. Serves as a liaison between the clinical staff and insurance payers.
11. Collects deductible, co-pay and all other applicable payments.
12. Performs other duties as assigned.
Arkansas Children's is the only healthcare system in the state solely dedicated to caring for Arkansas' more than 700,000 children. The private, non-profit organization includes two pediatric hospitals, a pediatric research institute and USDA nutrition center, a philanthropic foundation, a nursery alliance, statewide clinics, and many education and outreach programs — all focused on fulfilling a promise to define and deliver unprecedented child health. Arkansas Children’s Hospital (ACH) is a 336-bed, Magnet-recognized facility in Little Rock operating the state’s only Level I pediatric trauma center; the state's only burn center; the state's only Level IV neonatal intensive care unit; the state's only pediatric intensive care unit; the state’s only pediatric surgery program with Level 1 verification from the American College of Surgeons (ACS); the state’s only magnetoencephalography (MEG) system for neurosurgical planning and cutting-edge research; and the state's only nationally recognized pediatric transport program. Arkansas Children’s Hospital is nationally ranked by U.S. News & World Report in seven pediatric specialties (2022—2023): Cancer, Cardiology & Heart Surgery, Diabetes & Endocrinology, Nephrology, Neurology & Neurosurgery, Pulmonology and Urology. Arkansas Children’s Northwest (ACNW), the first and only pediatric hospital in the Northwest Arkansas region, is a level IV pediatric trauma center. ACNW operates a 24-bed inpatient unit; a surgical unit with five operating rooms; outpatient clinics offering over 20 subspecialties; diagnostic services; imaging capabilities; occupational therapy services; and Northwest Arkansas' only pediatric emergency department, equipped with 30 exam rooms. Generous philanthropic and volunteer engagement has sustained Arkansas Children's since it began as an orphanage in 1912, and today ensures the system can deliver on its promise of unprecedented child health. To learn more, visit archildrens.org.
