Prior Authorization Specialist

Using discretion and independent judgment, the Payor Relations Specialist manages the pre-certification and prior authorization of referrals scheduled for admission to the Acute Inpatient Rehabilitation Hospital. Follows the Select Workflow Process for initiating and completing patient authorizations. Takes full responsibility for following the “Workflow Process” and ensures each referral follows the process, from taking the initial referral until final disposition, acceptance or denial. As appropriate, submits the preadmission assessments completed by clinical liaisons to the insurance company. Ensures documentation meets standards and expectations by working and mentoring team as needed. Obtains timely authorization of all patients requiring pre-certification and is accountable for conversion percentage and results. Ensures all policies governing commercial pre-certification and authorization are followed to minimize financial risk.