AUTHORIZATION SPECIALIST - KRONENWETTER CLINIC

Aspirus, Inc; Northern (KY); Hybrid; USD 42,000 - 52,000; Full time

Benefits offered by this job

Full benefits package

Time away from work accrual

Retirement plans

Wellness program

Job summary

Aspirus Health Kronenwetter Clinic is seeking an Authorization Specialist to join our team. This role ensures accurate prior and ongoing authorizations by collecting demographic, insurance, and clinical information.

The position requires collaboration with the patient and clinical staff, meticulous data entry, and in-depth knowledge of payer policies. Full-time 0.8 FTE with supportive benefits provided.

Qualifications

• Experience in a healthcare setting and familiarity with payer processes.
• Ability to gather and verify demographics, insurance, and clinical information.
• Knowledge of ICD-10 and CPT coding and medical forms.
• Proficient computer skills with attention to detail and accuracy.

Responsibilities

• Process prior authorizations accurately and timely.
• Collect and verify patient demographics, insurance, and clinical information.
• Coordinate with intake, clinicians, and patients to resolve authorization issues.
• Maintain HIPAA compliance and documentation accuracy.
• Track and update authorization statuses and communicate with payers.
• Thrive in a fast-paced clinic environment with changing deadlines.

Skills

Healthcare experience

ICD-10 CPT knowledge

EMR software

HIPAA compliance

Communication skills

Data entry

Education

High School diploma or equivalent

Associate degree in Health Administration or related field

Tools

EMR systems

Job description

Compassion. Accountability. Collaboration. Foresight. Joy.

These are the Aspirus Core Values; and we are looking for the BEST around to join us as we demonstrate those values Every. Single. Day.

Aspirus Health in Kronenwetter, WI is seeking a AUTHORIZATION SPECIALIST to join our KRONENWETTER CLINIC team!

The Authorization Specialist is critical to ensure accurate prior and ongoing authorizations. This position collects demographic, insurance, and clinical information from intake department and clinicians to ensure reimbursement requirements are met. Coordination and communication with the patient and clinical team is key for successful financial analysis and clearance. Position requires the ability to multi-task, attention to detail, and requires a high degree of accuracy and timely submission of authorization requests.

The ideal candidate will have experience within the healthcare industry. The key areas that support one's ability to be successful are knowledge and experience in correlation with medications, prior authorizations, as well as medical forms. Please refer to the experience/qualifications section below for the other requirements and/or preferred skills and knowledge.

HOURS: Full Time 0.8 FTE, 64 Hours Biweekly

Experience/Qualifications

• Knowledge of office procedures normally acquired through completion of a High School diploma, GED, or equivalent combination of education and experience.
• Minimumof2 years' experience in a business office or healthcare setting preferred.
• Intermediate knowledge of ICD-10 and CPT codes preferred.
• Associate degree in Business Administration or Health Care Business Services or other applicable area preferred.
• Ability to proficiently use a computer and type required; experience with the electronic medical record strongly preferred.
• Previous Medical Clinic experience preferred.
• Working and applied knowledge of coding principles, Medicare, Medicaid, and commercial insurance practices highly recommended.
• Excellent written and oral communication skills with a high degree of professionalism.
• Demonstrates accuracy in record keeping and documentation.
• Able to maintain a positive service attitude under the stress of changing conditions/job demands.
• Demonstrates ability to organize multiple activities and effectively handle a fast-paced, changing workload with daily deadlines.
• Possesses an overall understanding of insurance and government authorizations in a health care organization.
• Significant experience with health insurance utilization management services
• Possesses the ability to troubleshoot and work independently.
• Is self-directed and displays good judgment with attention to detail.
• Possesses the ability to work with many changes within the insurance and government payer process.
• Ability to work cooperatively and effectively with providers, patients, staff, and the public.
• Ability to establish priorities and coordinate work activities.
• Ability to maintain confidentiality with regard to all phases of work.
• Knowledge of federal and state laws regarding HIPAA and release of information.

Employee Benefits

• Full benefits packages available for part- and full-time status.
• Time away from work accrual.
• Retirement plans available.
• Wellness program for employees and their families.

Our Mission

We heal people, promote health and strengthen communities.

Our Vision

Aspirus is a catalyst for creating healthy, thriving communities, trusted and engaged above all others.

As an Aspirus team, we demonstrate caring, we plan to impact the future, work with happiness and enthusiasm, recognize our power to make a difference and improve the health of our communities.

Aspirus Health is a nonprofit, community-directed health system based in Wausau, Wisconsin, serving northeastern Minnesota, northern and central Wisconsin and the Upper Peninsula of Michigan. The health system operates 18 hospitals and 130 outpatient locations with nearly 14,000 team members, including 1,300 employed physicians and advanced practice clinicians. For more information visit aspirus.org.