Medicaid Prior Authorization Specialist I

Yukon-Kuskokwim Health Corp.; Bethel (AK); On-site; USD 60,000 - 80,000; Full time

Job summary

A regional health organization in Bethel is seeking a Medicaid Prior Authorization Specialist I. This role is responsible for the accurate submission and recovery of healthcare claims, requiring a high school diploma and at least one year of experience in healthcare reimbursement and customer service. The organization offers generous PTO, healthcare coverage, and an inclusive work environment.

Benefits

Generous PTO – starting at 4.5 weeks per year

Eleven paid holidays

Comprehensive healthcare coverage

Life and Disability Insurance

Flexible Spending Account

Employee Wellness Center

Qualifications

• Must have a High School diploma or GED.
• One year of experience in health care reimbursement.
• One year of customer service experience.

Responsibilities

• Submit and recover healthcare claims accurately and timely.
• Assist senior specialists with workload.
• Resolve account balances coordination with payers.

Skills

Experience in health care reimbursement

Customer service experience

Typing speed of 50 wpm

Knowledge of billing submission types

Experience using office machinery

Microsoft Office Suite

Education

High School diploma or GED

College level course in Medical Terminology

Tools

Cerner Millennium Revenue Cycle

Job description

Medicaid Prior Authorization Specialist I Department Medicaid Prior Authorization Location Bethel Employment Duration 80 Full time

Medicaid Prior Authorization Specialist I

We are working together to achieve excellent health. Come join us!

The Yukon-Kuskokwim Health Corporation is a Tribal health care organization, serving nearly 30,000 people living across rural, southwest Alaska in villages with populations from about 10 to more than 1,000. Bethel, the regional hub and location of the only hospital in the region, has a population of nearly 7,000. The Yukon-Kuskokwim Delta is home to thousands of lakes and two primary rivers—the Kuskokwim and Yukon.

We offer a broad range of employment opportunities and the chance to make a meaningful impact on the health of people in the region.

Position Summary:

Responsible for accurate and timely submission and recovery of healthcare claims. As the entry level Recovery Specialist, this individual will assist senior specialists with workload and work assigned tasks from Lead. Responsible for all routine actions required in resolving account balances. Incumbent must have the ability to adjust to an uneven flow of incoming workload. Ability to coordinate reimbursement resolution with all payer types. Must be able to demonstrate excellent time management skills and be able to set timelines and goals to ensure that all assigned duties are accomplished within established time frames.

Position Qualifications:

• High School diploma or GED required
• Degree requirement can be waived on a year for year basis for a combination of education and experience
• One (1) year experience in health care reimbursement
• One (1) year customer service experience
• HFMA CRCR Preferred
• Experience using office machinery including printers, photocopiers, fax machines, and multi-line phone systems
• IHS Tribal Billing knowledge preferred
• Experience with Cerner Millennium Revenue Cycle preferred
• College level course in Medical Terminology preferred
• Versed in Microsoft Office Suite
• Typing speed of 50 wpm
• 10-key calculator skills, by touch
• Ability to speak Yupik preferred
• Must be able to demonstrate working knowledge of the billing submission types 1500, 1450 (UB04), 837I, 837P, 837D

Benefits Include:

• Generous PTO – starting at 4.5 weeks per year, accrued over time
• Eleven paid holidays
• Comprehensive healthcare coverage
• Life and Disability Insurance
• Flexible Spending Account
• Employee Wellness Center

Additional Information:

ID: 16124

Location: Bethel

Department: Medicaid Prior Authorization

Employment Duration: 80 Full time

Temporary Status: Not Applicable

Hours per Week: 40

Minimum Hourly Pay: 21.78

FLSA Status: Non-exempt

Yukon Kuskokwim Health Corporation is an Affirmative Action/Equal Opportunity Employer. All qualified individuals will receive consideration for employment without regard to race, ethnicity, age, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status and any other basis protected by law. Individuals with disabilities needing assistance in the recruitment process are encouraged to contact Human Resources directly.

Under P.L. 93-638, preference is given to Alaska Native/American Indian applicants.

For more information, please contact the YKHC Recruitment Department at [e-mail] or phone [phone] and ask to speak with a recruiter.