Prior Authorization/Referral Specialist
FroedtertSouth•Kenosha, WI
About The Position
A Pre-Authorization/Referral Specialist is responsible for determining insurance eligibility/benefits and ensuring pre-certification (authorization/referral) requirements are met for both the facility and professional services. The Pre-Authorization/Referral Specialist provides detailed documentation and communication with both payors and clinicians to obtain prior-authorizations. Obtains clinical information to support medical necessity.
Requirements
- Experience in pre-authorization/referrals, patient registration, insurance verification and health insurance plans
- Knowledge of online insurance pre-authorization process and working with various payors
- Excellent computer and customer service skills
- Familiarity with Medical Terminology
- Demonstrated ability to efficiently organize work, while maintaining a high level of accuracy and productivity
- Knowledge of ICD-10, CPT and HCPC codes and use
- Familiarity with internet, email and Microsoft Office
- Effective written and verbal communication skills required
Benefits
- Medical, dental and vision benefits available
- 403(b) company match available
- Tuition reimbursement
- Employee discount program
- Competitive PTO
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What This Job Offers
Career Level
Mid Level
Education Level
No Education Listed
