Preauthorization and Referral Assistant

Beloit Health System; Town of Turtle (WI); On-site; USD 38,000 - 52,000; Full time

Job summary

Beloit Health System is seeking a Preauthorization and Referral Assistant to join our Insurance & Billing team. You will obtain insurance preauthorizations, process referrals, verify benefits, and coordinate with providers, payers, and patients to ensure timely access to care.

The role requires strong organization, experience in medical office operations, and a commitment to delivering excellent patient service.

Qualifications

• High School graduate or equivalent.
• Knowledge of medical terminology or prior insurance experience.
• Experience in medical office operations or Medical Assistant experience.
• Excellent organizational and communication skills.
• Ability to manage multiple priorities in a fast-paced environment.
• Maintain confidentiality of patient information.
• Proficiency with MS Word and Excel.
• HIPAA compliance and regulatory adherence.

Responsibilities

• Obtain and track insurance preauthorizations for procedures and services.
• Process incoming and outgoing referrals accurately and timely.
• Verify patient insurance coverage, eligibility, benefits, and authorization requirements.
• Communicate with insurance companies regarding authorization status, denials, appeals, and requests for documentation.
• Coordinate with providers and clinical staff to gather medical records and supporting documents.
• Notify patients of authorization and referral status, requirements, and issues.
• Maintain accurate records in the EHR and referral tracking systems.
• Monitor authorization expiration dates and renewals as needed.
• Assist with resolving billing and insurance-related issues connected to referrals and authorizations.
• Support front office and administrative functions as assigned.
• Reporting relationship: Director of Revenue Cycle.

Skills

Organizational skills

Verbal communication

Interpersonal skills

Initiative

Attention to detail

Multi-tasking

Confidentiality

Regulatory compliance

Education

High School diploma or equivalent

Tools

MS Word

Excel

Job description

Beloit Health System is looking to add a Preauthorization & Referral Assistant to our Insurance & Billing team!

• Shift: First
• Schedule: 8a – 4:30p
• Hours per week: 40
• Benefits Status: Eligible
• Department: Beloit Clinic Insurance/Billing

We are seeking a detail-oriented and patient-focused Preauthorization and Referral Assistant to join our healthcare team. This role is responsible for obtaining insurance preauthorizations, processing referrals, verifying patient benefits, and coordinating with providers, insurance companies, and patients to ensure timely access to care. The ideal candidate will have strong organizational skills, experience in medical office operations, and a commitment to delivering excellent patient service.

• Obtain and track insurance preauthorizations for procedures, diagnostic studies, medications, and specialty services.
• Process incoming and outgoing referrals accurately and in a timely manner.
• Verify patient insurance coverage, eligibility, benefits, and authorization requirements.
• Communicate with insurance companies regarding authorization status, denials, appeals, and additional documentation requests.
• Coordinate with providers and clinical staff to gather necessary medical records and supporting documentation.
• Notify patients of authorization and referral status, appointment requirements, and any insurance-related issues.
• Maintain accurate records in the electronic health record (EHR) system and referral tracking systems.
• Monitor authorization expiration dates and obtain renewals as needed.
• Ensure compliance with HIPAA and all applicable healthcare regulations.
• Assist with resolving billing and insurance-related issues connected to referrals and authorizations.
• Support front office and administrative functions as assigned.

Job Requirements:

• High School graduate or equivalent.
• Initiative and sound judgment.
• Excellent organizational, verbal communication and interpersonal relation skills to be utilized with providers, patients, public staff and payers.
• Must have knowledge of medical terminology, previous insurance experience, or Medical Assistant experience.
• Excellent computer skills, with MS Word and Excel preferred.
• Must adhere to established regulatory agencies, Beloit Health System, and department policies, rules and regulations.
• Strong attention to detail and organizational skills.
• Excellent verbal and written communication skills.
• Ability to manage multiple priorities in a fast-paced environment.
• Maintain ethical conduct and keep confidential personal, financial and medical information about patients
• Reporting Relationship: Director of Revenue Cycle.