St. Johns Medical Center
  • Central Scheduling
  • Jackson, WY, USA
  • Full Time

Embraces the vision of Patient Financial Services: "To provide highly regarded and desirable Patient Financial Services that are caring, honorable, and innovative." Under the direction of the Patient Financial Services Manager, this role supervises Financial Authorization Specialists. This role is responsible for ensuring optimal
performance in acquiring authorizations in a timely manner. Engages in efficient processing of assigned tasks and projects while providing an exceptional level of customer service for all customers. Has a full understanding of all Patient Financial Services, and daily engagement in quality assurance and process accuracy.


Authorization of Medical Services
1. Authorizes medical services for patients. Contacts insurance companies via phone or website to ensure that eligibility and benefit information is obtained, and authorization is in place when necessary. Documents all contacts in the hospital information system.
2. Maintains a balance with regards to the interest of the hospital and the patient situation or concerns when resolving accounts.

Advanced Knowledge and Expertise
1. Advanced knowledge of medical terminology and clinical documentation.
2. Has the ability to execute specialized projects and make critical decisions based on the understanding of patient financial services, as well as insurance payer regulations and requirements.
3. Understands and demonstrates full systems thinking when solving problems.
4. Analyzes the full life of an account to identify and report impact opportunities, and implements actions based on functional decision making strategies.

Timely Decision Making
1. Demonstrates an ability to set priorities within established deadlines and time frames.
2. Maintains an awareness of the time sensitivity of each case and has the ability to get each case resolved in an appropriate time frame.

1. Continually talks with doctor office staff for clarification on patient cases. This can include establishing the Coordination of Care for those patients.
2. Consistent connecting with insurance companies, and other internal contacts to ensure benefit eligibility and requirements are confirmed. Documents appropriate information in the hospital EHR.
3. Immediately communicates any denial of services to Billing and/or Scheduling personnel.

Problem Solving and Improvement Activities
1. Autonomously applies sound judgment to solve operational problems, appropriately following up with team members and leadership to address. Participates in the launch, development, implementation, and control of improvement projects.
2. Should a service not be approved by the insurance company, the specialist reviews the clinical information, and determines if the patient should proceed or look at alternative options.


Minimum Education
Required: High School Degree or GED equivalent
Preferred: Associates or Bachelors Degree in a related field, HFMA, Six Sigma or other related professional certifications

Minimum Work Experience
Required:2 years of healthcare hospital patient accounting experience, Advanced knowledge of insurance requirements and proven application of complex patient accounting skills
Preferred: 3+ years of healthcare hospital patient accounting experience


Working Conditions
Normal office hours, Monday through Friday. Virtual office. Frequent interruptions and stressful situations. Contact with patients, coworkers, insurance companies, vendors and community members under variety of circumstances.

Physical Requirements
80 to 90% of day sitting and computer use. Heavy phone usage. Intermittent standing and walking. Ability to lift 20 lbs.

Direct Reports
Reports to
Financial Authorizations Supervisor

St. Johns Medical Center
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