PRE-AUTHORIZATION SPECIALIST, FCH - ENTERPRISE REGISTRATION

Froedtert Health; Menomonee Falls (WI); On-site; USD 29,000 - 39,000; Full time

Benefits offered by this job

Paid time off

Career growth opportunities

Tuition assistance

403b retirement plan

Health, dental, vision, life insurance

Wellness programs and assistance

Job summary

Froedtert Health in Wisconsin seeks a Pre-Authorization Specialist to verify eligibility, obtain insurance benefits, and secure pre-certifications for inpatient and outpatient services. You will determine payer requirements and communicate with payers and clinical partners, documenting details in the patient record.

Required: at least 2 years in hospital billing/pre-authorization or insurance verification and a high school diploma. Benefits include PTO, career growth, and comprehensive coverage.

Qualifications

• Minimum 2 years in hospital billing/pre-authorization or insurance verification.
• Knowledge of Medicare, Medicaid, HMOs and PPOs.
• High School diploma required.

Responsibilities

• Verify eligibility and obtain necessary authorizations prior to services.
• Communicate with payers and clinical partners to ensure payer requirements are met.
• Document necessary information in patient records and maintain accuracy.

Skills

Customer service

Insurance systems

Typing

Medical terminology

Organization skills

Education

High School Diploma

Job description

#BeHere

Location: US:WI:MENOMONEE FALLS at our WOODLAND PRIME 400 facility.

This job is REMOTE.

FTE: 1.000000

Standard Hours: 40.00

Shift: Shift 1

Job Summary

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.

Experience Description

A minimum of 2 years experience in hospital billing/pre-authorization or insurance verification with 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.

Education Description

High School diploma or equivalent is required.

Special Skills Description

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.

Compensation, Benefits & Perks At Froedtert Health

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

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.

Equal Opportunity Employer Statement

We are proud to be an Equal Opportunity Employer who values and maintains an environment that attracts, recruits, engages and retains a diverse workforce. We welcome protected veterans to share their priority consideration status with us at 262-439-1961. We maintain a drug-free workplace and perform pre-employment substance abuse testing. During your application and interview process, if you have a need that requires an accommodation, please contact us at 262-439-1961. We will attempt to fulfill all reasonable accommodation requests.