Preauthorization & Referral Specialist

Beloit Health System; Beloit (WI); On-site; USD 38,000 - 46,000; Full time

Job summary

Beloit Health System is seeking a Preauthorization & Referral Assistant to join the Insurance & Billing team. The role focuses on obtaining prior authorizations and referrals for procedures, admissions, tests, and medications.

The candidate will respond to inquiries from providers, staff, patients, payers, and employers, verify information in the billing/medical records system, and assist with payer communications to ensure timely reimbursements.

Qualifications

• Requires high school diploma or equivalent; initiative and good judgment.
• Excellent organizational and interpersonal skills for interaction with providers, patients, and payers.
• Strong verbal communication and written communication abilities.
• Proficient computer skills; MS Word and Excel preferred.

Responsibilities

• Obtain prior authorizations and referrals for procedures, admissions, tests, and medications.
• Promptly respond to inquiries from providers, staff, patients, payers, and employers via phone, mail, or in person.
• Verify medical and insurance information using the billing/medical records system and assist with approvals.
• Contact payers and patients to complete preauthorization requirements and relay updates to providers.
• Review daily hospital schedules to ensure preauthorizations are completed and notify providers as needed.
• Document relevant details in the Practice Management System.
• Use work queues to manage claims at various transmission stages and ensure timely processing.
• Maintain knowledge of payer rules and use payer websites to complete authorizations and referrals.
• Interact positively with patients, providers, coworkers, and managers.

Skills

Organizational skills

Verbal communication

Interpersonal skills

Computer skills

Education

High School diploma or equivalent

Tools

MS Word

Excel

Job description

Beloit Health System is seeking a Preauthorization & Referral Assistant to join the Insurance & Billing team. The role focuses on obtaining prior authorizations and referrals for procedures, admissions, tests, and medications.

The candidate will respond to inquiries from providers, staff, patients, payers, and employers, verify information in the billing/medical records system, and assist with payer communications to ensure timely reimbursements.