[Hiring] Pre-Authorization Specialist @Froedtert

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.
• 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: $21.16 - $28.78 (hourly).
• 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.

Company Description

The Froedtert & the Medical College of Wisconsin regional health network is a partnership between Froedtert Health and the Medical College of Wisconsin supporting a shared mission of patient care, innovation, medical research, and education. Our health network operates eastern Wisconsin's only academic medical center and adult Level I Trauma center engaged in thousands of clinical trials and studies. The Froedtert & MCW health network, which includes ten hospitals, nearly 2,000 physicians, and more than 45 health centers and clinics draw patients from throughout the Midwest and the nation.