Email Opening Apply Now Title Prior Authorization Specialist  Full-Time/Part-Time Full-Time   Exempt/Non-Exempt Non-Exempt   Description PURPOSE: The Prior Authorization Specialist (PAS) is an essential role responsible for facilitating exceptional patient experience, by securing authorizations for all scheduled services related to behavioral health including but not limited to Intensive Outpatient Program, Medication Assisted Treatment across the department. JOB SUMMARY: The Prior Authorization Specialist is responsible for obtaining and verifying prior authorizations from insurance payers for behavioral health services. Prior to a patient’s treatment, the Prior Authorization Specialist reviews patient insurance and clinical documents and contacts payers to receive prior authorization from the insurance payer. Authorization Specialists are responsible for verifying the treatment is authorized and verifying that required payer documentation and authorization records are on file.   Northern Nevada HOPES is a community health and wellness center serving the Northern Nevada area. We are a non-profit community health center located in a historic and quaint area of downtown Reno, Nevada. Our expert care teams provide integrated medical and wellness services to individuals and families in our community. We welcome everyone, and meet them wherever they are, providing a safe and accepting place to access comprehensive, patient-centered healthcare services. Comprehensive, integrated care is the cornerstone of the patient-centered medical home; Northern Nevada HOPES has a robust offering of services and collaborates with other service providers in the community to ensure our patients have a comprehensive, well-rounded program to meet their individual health and wellness needs. The medical home model holds promise as a way to improve health care in America by transforming how primary care is organized and delivered. At HOPES we understand there are many determinants of health and that a range of personal, social, economic, and environmental factors influence health. Named one of the Best Places to Work in Northern Nevada for 2015, 2018 and 2019 we offer the same attention to ensuring our employees have work/life balance and the opportunity to grow and develop their careers. We offer a second-to-none benefits package (where employee health, vision, dental and basic life insurance is free of charge for full-time employees and prorated premiums for part-time employees), very competitive compensation, generous paid time off, and a chance to partner with amazing care providers to changes lives. Check out our AMAZING benefits program at https://www.nnhopes.org/wp-content/uploads/2023/12/HOPES-Benefits-Overview-23-24.pdf. At HOPES, all employees serve as ambassadors to our patients and the community. Your co-workers at HOPES are one of the many contributing factors to HOPES being named one of Northern Nevada's Best Places to Work three times in the last five years.  To learn more about the Key Accountabilities of HOPES Squad members, take a look at https://www.nnhopes.org/wp-content/uploads/2020/03/HOPES-Squad-KAAs.pdf. Fit is as important as function at HOPES. We enjoy a VERY special collaborative culture that thrives on open communication and valuing everyone's contribution to the team. We are as unique as the populations we serve! However, we all agree on our dedication to optimizing wellness for the people we serve and understand we ALL are responsible for the mission of Northern Nevada HOPES. To find out more about HOPES, visit our website at https://www.nnhopes.org/. We have a great mission and have been inducted into the Best Places to Work Hall of Fame.  All our careers are listed on our Careers page at https://www.nnhopes.org/about/careers/.If you'd like to learn more about what HOPES is doing in the community, sign up for our newsletter at https://www.nnhopes.org/newsletter/. We are a Drug-Free Workplace and utilize E-Verify to confirm work eligibility.     Position Requirements Due to real and potential conflicts of interest that exist when HOPES Behavioral Health providers render services to their coworkers, it is HOPES’ policy (Policy HR0005) that HOPES employees may not access HOPES Behavioral Health Services. For the same reason, current Behavioral Health patients/clients cannot be employed by HOPES. Accordingly, you hereby acknowledge and understand that if you are receiving services from a HOPES Behavioral Health provider at the time you are offered and accept employment with HOPES, you have the option of rescinding your acceptance of employment or finding a new behavioral health provider outside of HOPES before starting employment with HOPES.   High school diploma or General Education Development (GED) equivalent required Valid BLS required prior to hire, per HRSA compliance. Knowledge and/or work experience related to Behavioral Health/Mental Health third-party payors, copays, deductibles, and authorizations. Strong ability to navigate and research information on payer websites and payer documentation and speak with payer representatives over the phone. Experience working with insurance payers and obtaining prior authorizations. Strong computer skills, including Microsoft Office/Outlook /Word/Excel skills. Ability to learn new software quickly. Knowledge of Medical terminology and process Extremely Detail oriented. Ability to work on short deadlines. Ability to Multi-task Strong time management and organizational skills     About the Organization Northern Nevada HOPES is a nonprofit community health center in downtown Reno, NV that offers integrated medical care and wellness services. We welcome patients, wherever they are in life, and provide them with compassionate, high-quality healthcare. Our growing list of services includes adult and pediatric primary care, chronic disease management, wellness and nutrition, behavioral health counseling, substance use counseling, case management, a pharmacy, and more. Our team-based approach to care gives patients access to a range of comprehensive services in one convenient location. For medically underserved populations, our one-stop-shop healthcare model reduces barriers to care and increases the likelihood of maintaining long-term health. HOPES accepts most insurance plans, Medicaid, Medicare, and the uninsured. For the uninsured, we offer discounted services based on a sliding fee scale.   EOE Statement Northern Nevada HOPES is an Equal Opportunity Employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination on the basis of race, color, religion, sex (including pregnancy, gender identity or expression, and sexual orientation), parental status, national origin, age, physical or mental disability, genetic information or veteran status in all employment practices.   Salary Range $20 - $22.20   This position is currently accepting applications. 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