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Role Description
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.
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 required
• Prior experience in a business office position with strong customer service background preferred
• High School diploma or equivalent is required
Requirements
• Exceptional customer relations skills required
• 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
Benefits
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.
• 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