Job Description
Role Description
- The Pre-Authorization Specialist is a member of the Pre-Authorization Department who is responsible for:
- Verifying eligibility and obtaining insurance benefits.
- Ensuring pre-certification, authorization, and referral requirements are met prior to the delivery of inpatient, outpatient, and ancillary services.
- Determining which patient services have third party payer requirements.
- Obtaining the necessary authorizations for care.
- Providing detailed and timely communication to both payers and clinical partners.
- Documenting the appropriate information in the patient's record.
- Performing other duties as assigned.
- Qualifications
- A minimum of 2 years experience in hospital billing/pre-authorization or insurance verification.
- Demonstrated knowledge of health insurance plans including Medicare, Medicaid, HMO's, and PPO's.
- Prior experience in a business office position with strong customer service background preferred.
- High School diploma or equivalent is required.
- Exceptional customer relations skills required.
- Knowledge of online insurance eligibility systems preferred.
- Excellent typing and computer skills preferred.
- Familiarity with Medical Terminology preferred.
- Demonstrated ability to efficiently organize work and maintain a high level of accuracy and productivity.
- Requirements
- None required for licensure.
- Benefits
- 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.
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