Pre-Certification Specialist

Bone and Joint Center, S.C. • Wausau, WI

3d • $19 - $28

About The Position

Bone & Joint is seeking a Pre-Certification Specialist to join its Pre-Certification/Verification of Benefits Team. The role suits someone who can work in a fast-paced environment, provide great customer service, pay close attention to detail, adapt quickly to changing demands, and promote positivity. The position works with multiple departments across Bone & Joint and with external organizations, including insurance carriers and hospital systems.

The primary focus is obtaining insurance prior authorizations—online or by phone—for provider-ordered procedures, surgery, high-end imaging, durable medical equipment, and other services. The specialist also verifies benefits for all patients to confirm active coverage and that their insurance plan is accepted at Bone & Joint clinics and Walk-in locations.

Bone & Joint is an independent orthopedic, pain management, podiatric, physical therapy, and occupational therapy organization with locations throughout Central Wisconsin. Its mission is to be the best place for patients to receive care, employees to work, and physicians to practice medicine.

The regular schedule is Monday through Friday, 8:30 a.m. to 5:00 p.m., with a 30-minute lunch. Additional flexibility may be offered after training, based on business needs.

Requirements

• High school diploma or equivalent.
• Patience and the ability to work with people at all levels, both internally and externally.
• Great attention to detail.
• At least 1 year of experience with online and telephone prior authorizations for services.
• Experience with and knowledge of government, commercial, program, and private insurance.

Responsibilities

• Obtain insurance prior authorizations online or by phone for provider-ordered procedures, surgery, high-end imaging, durable medical equipment, and other services.
• Verify benefits for all patients to confirm active coverage and whether their insurance plan is accepted at Bone & Joint clinics and Walk-in locations.
• Work and communicate with providers, clinical teams, Ambulatory Surgery Center teams, Registration, coding and billing, therapy teams, insurance carriers, and outside hospital systems.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED