Minimum of 2 years experience in hospital billing/pre-authorization or insurance verification., High School diploma or equivalent is required., Exceptional customer relations skills and knowledge of health insurance plans are essential., Familiarity with medical terminology and online insurance eligibility systems is preferred..
Key responsabilities:
Verify patient eligibility and obtain insurance benefits prior to service delivery.
Ensure pre-certification, authorization, and referral requirements are met.
Communicate effectively with payers and clinical partners to facilitate compliance.
Document necessary information in the patient's record accurately and timely.
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Location: US:WI:MENOMONEE FALLS at our WOODLAND PRIME 400 facility.
This job is REMOTE.
FTE: 1.000000
Shift: Shift 1
Schedule: Monday - Friday 8-430 CST.
Job Summary:
The Pre-Authorization Specialist is a member of the Pre-Authorization Department who is responsible for verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to the delivery of inpatient, outpatient, and ancillary services. This individual determines which patient services have third party payer requirements and is responsible for obtaining the necessary authorizations for care. The Pre-Authorization Specialist provides detailed and timely communication to both payers and clinical partners in order to facilitate compliance with payer contractual requirements and is responsible for documenting the appropriate information in the patient's record. Other duties as assigned.
EXPERIENCE DESCRIPTION:
A minimum of 2 years experience in hospital billing/pre-authorization or insurance verification with demonstrated knowledge of health insurance plans including: Medicare, Medicaid, HMO's and PPO's required. Prior experience in a business office position with strong customer service background preferred.
EDUCATION DESCRIPTION:
High School diploma or equivalent is required.
SPECIAL SKILLS DESCRIPTION:
Exceptional customer relations skills required. Knowledge of online insurance eligibility systems, preferred. Excellent typing and computer skills is preferred. Familiarity with Medical Terminology, preferred. Demonstrated ability to efficiently organize work and maintain a high level of accuracy and productivity is preferred.
Compensation, Benefits & Perks At Froedtert Health
Pay is expected to be between: (expressed as hourly) $21.16 - $28.78. Final compensation is based on experience and will be discussed with you by the recruiter during the interview process.
Froedtert Health Offers a variety of perks & benefits to staff, depending on your role you may be eligible for the following:
Paid time off
Growth opportunity- Career Pathways & Career Tuition Assistance, CEU opportunities
Academic Partnership with the Medical College of Wisconsin
Referral bonuses
Retirement plan - 403b
Medical, Dental, Vision, Life Insurance, Short & Long Term Disability, Free Workplace Clinics
Employee Assistance Programs, Adoption Assistance, Healthy Contributions, Care@Work, Moving Assistance, Discounts on gym memberships, travel and other work life benefits available
The Froedtert & the Medical College of Wisconsin regional health network is a partnership between Froedtert Health and the Medical College of Wisconsin supporting a shared mission of patient care, innovation, medical research and education. Our health network operates eastern Wisconsin's only academic medical center and adult Level I Trauma center engaged in thousands of clinical trials and studies. The Froedtert & MCW health network, which includes ten hospitals, nearly 2,000 physicians and more than 45 health centers and clinics draw patients from throughout the Midwest and the nation.
We are proud to be an Equal Opportunity Employer who values and maintains an environment that attracts, recruits, engages and retains a diverse workforce. We welcome protected veterans to share their priority consideration status with us at 262-439-1961. We maintain a drug-free workplace and perform pre-employment substance abuse testing. During your application and interview process, if you have a need that requires an accommodation, please contact us at 262-439-1961. We will attempt to fulfill all reasonable accommodation requests.
Required profile
Experience
Spoken language(s):
English
Check out the description to know which languages are mandatory.