Authorization Representative

Chartwell Midwest; Town of Middleton (WI); Hybrid; USD 42,000 - 62,000; Full time

Benefits offered by this job

Health insurance

Dental & vision

401K matching

Employee Assistance Program

PTO

Flexible Spending Account

Job summary

Chartwell Midwest is seeking a Billing Continuity Representative in Middleton, WI. You will obtain initial and renewal authorizations, verify insurance coverage, and support patients with compliance and billing communications.

The role offers onsite work with remote-work option after training, requires living within two hours drive, and includes competitive benefits with PTO, 401K matching, and flexible spending options.

Qualifications

• Experience obtaining renewal and initial authorizations.
• Verifies insurance eligibility and required qualifications.
• Communicates with patients by phone and mail about compliance.
• Familiar with Medicare and Medicaid rules and billing practices.
• Ability to monitor documentation requested by payers.

Responsibilities

• Obtain renewal and initial authorizations after dispensing.
• Follow up on convert-to-purchase authorizations and renewals.
• Explain patient responsibilities and insurance coverage on calls/letters.
• Review monthly reports for insurance changes and Medicare benefits.
• Ensure documentation is complete for reimbursements.

Skills

Insurance verification

Authorizations (initial/renewal)

Patient communication

Medicare/Medicaid rules

Brightree

Tools

Brightree

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Authorization Representative

Full-time Regular Middleton, WI, US

4 days ago Requisition ID: 1646

Position Summary: The Billing Continuity Representative is responsible for obtaining initial and/or renewal authorizations, performing insurance verification and follow-up. This position also monitors and works with patients regarding compliance for insurance coverage. Serves as communication liaison between team members, third party payers, patients, and billing for financial arrangements.

Remote work after successful completion of training is an option! You must come onsite once quarterly after onsite training is completed. Must live within 2 hours driving distance to our location in Middleton. We provide the equipment to do your job from home! We offer competitive benefits; PTO is accrued from the day you start offering 3+ weeks a year!

Essential Job Knowledge:

• Obtains all renewal authorizations as well as initial authorizations that are needed after dispensing.
• Obtains all convert to purchase authorizations, follows up on all rentals compliance for convert to purchase, and renewal prescriptions.
• Communicates with patients via phone calls and letters explaining their state of compliance and their responsibility to become compliant.
• Answers questions regarding insurance coverage of services.
• Checking insurance eligibility and verifying qualifications needed for all insurance changes.
• Monitors and forwards any documentation requested by payers for reimbursement purposes.
• Reviews monthly Brightree report which identifies patients that have insurance changes or will be eligible for Medicare benefits based on their age.
• Is familiar with legislation that impacts the delivery of and billing of services.
• Reviewing and completing all WIPS and Tasks as assigned to Billing Continuity team and individual members.
• Follows procedures to monitor Medicare and Medicaid rules and regulations to assure appropriate and optimum reimbursement.
• Attends workshops, meetings, and seminars to keep the department abreast of the changes in legislation, regulations, and industry practices.
• Provides peer review input on selected employee performance reviews.
• Successfully completes initial and ongoing organizational and department education, training, and competency requirements.
• Infection Control: Understands, demonstrates, and follows organizational infection control guidelines (CDIC).
• Quality: Focuses on improving processes and champions efficiency in daily work activities.
• Safety: Promotes a culture of safety by taking accountability for individual actions, including but not limited to, promptly reporting errors or near misses via the organization’s occurrence reporting system and participating in developing improved safety processes, as appropriate. (ADM015, ADM016, OPS044, Mission Statement).
• Assures the federally required documents are obtained and maintained in a complete and timely manner.
• Performs other duties as assigned.

Benefits Include:

• Health,Dental, andVision coverage - Competitive premiums!
• 401K matching - we match 100% on the first 3% you contribute and then match 50% on the next 2% you contribute!
• Employee Assistance Program - A great resource when facing different situations in life! Confidential!
• PTO - Generous PTO! 8.92 hours accrued biweekly for a fulltime position (80 hours per pay period)
• Flex Spending Account