Nationwide Children's Hospital

Prior Authorization Specialist

Nationwide Children's Hospital  •  United States (Onsite)  •  3 months ago
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Job Description

Schedule: M-F (Day shift, 40 hours per week)

This is a temporary position without guarantee of conversion to full-time employment.

Coordinates patient accounts from prior authorization to point of bill payment or referral to collection, including processing billing for home health agencies to appropriate agencies, including Medicaid and self-pay. Maintains current knowledge of changes in billing requirements and regulations and assists in resolving billing problems. Essential Functions:

  • Verifies patient insurance coverage and eligibility for homecare services.
  • Processes and submits insurance claims for reimbursement.
  • Communicates with patients, insurance companies, and healthcare providers to resolve billing issues.
  • Maintains accurate and up-to-date patient records and billing information.
  • Monitors and tracks outstanding claims and follows up on unpaid or denied claims.
  • Ensures compliance with all relevant regulations and guidelines related to homecare billing and reimbursement.


Education Requirement:

High School Diploma or equivalent, required.


Licensure Requirement:

(not specified)


Certifications:

(not specified)


Skills:

(not specified)


Experience:

  • Two years ofexperience billing public and private insurers for medical services using computerized billing system, required.
  • Homecare services experience, preferred.


Physical Requirements:

OCCASIONALLY: Flexing/extending of neck, Lifting / Carrying: 0-10 lbs, Standing, Walking

FREQUENTLY: (none specified)

CONTINUOUSLY: Audible speech, Color vision, Computer skills, Decision Making, Depth perception, Hand use: grasping, gripping, turning, Hearing acuity, Interpreting Data, Peripheral vision, Problem solving, Repetitive hand/arm use, Seeing – Far/near, Sitting


Additional Physical Requirements performed but not listed above:

Talking on the phone / in person Frequently (34 - 66%)

"The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individuals so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under their supervision. EOE M/F/Disability/Vet"

Nationwide Children's Hospital

About Nationwide Children's Hospital

Nationwide Children’s is one of America's largest pediatric hospitals, an international leader in research and is ranked in all 10 specialties on U.S. News & World Report’s 2025-26 “America’s Best Children’s Hospitals” list. Our staff, comprised of 1,600 medical professionals and over 16,000 employees, provides state-of-the-art pediatric care for 1.8 million patient visits annually. And, according to the Children’s Hospital Association, Nationwide Children's is the #1 provider of pediatric surgery in the country.

Our doctors represent every major pediatric sub-specialty. With over 50 locations throughout Ohio, signature programs include heart, cancer, gastroenterology and neonatology care, all of which are internationally recognized. Tim Robinson is CEO of Nationwide Children’s Hospital, which includes the Abigail Wexner Research Institute at Nationwide Children’s Hospital, Nationwide Children’s Hospital Foundation and The Center for Family Safety and Healing at Nationwide Children’s Hospital.

As home to the Department of Pediatrics of The Ohio State University College of Medicine, Nationwide Children’s physicians train the next generation of pediatricians and pediatric specialists. The Abigail Wexner Research Institute at Nationwide Children’s Hospital is one of the Top 10 National Institutes of Health-funded freestanding pediatric research facilities. Nationwide Children’s remains true to the original mission since its founding in 1892 of providing care regardless of a family’s ability to pay. More information is available at NationwideChildrens.org.

Industry
Healthcare & Social Services
Company Size
10,000+ employees
Headquarters
Columbus, OH
Year Founded
1892
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