PRE-AUTHORIZATION SPECIALIST, FCH - ENTERPRISE REGISTRATION
About The Position
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.
Requirements
- 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
- Exceptional customer relations skills
- Knowledge of online insurance eligibility systems
- Excellent typing and computer skills
- Familiarity with Medical Terminology
- Demonstrated ability to efficiently organize work and maintain a high level of accuracy and productivity
Nice To Haves
- Prior experience in a business office position with strong customer service background
Responsibilities
- Verifying eligibility
- 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
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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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
