Precertification & Authorization Specialist

CHS Children's Hospital and Health System, Inc.; United States; On-site; USD 42,000 - 56,000; Full time

Job summary

Children's Wisconsin seeks a Financial Verification Representative to initiate precertification and authorizations for inpatient and outpatient services, verify insurance, and ensure smooth billing flow. The role involves patient pre-registration and entering authorization data into Epic with accuracy and timeliness, while educating families on the managed care process.

Strong organizational, analytical, and communication skills are required to handle multiple tasks in a fast-paced healthcare

Qualifications

• High school diploma or GED required.
• 2+ years of registration, scheduling or administrative support in healthcare or business settings.

Responsibilities

• Obtain precertification and prior authorization for inpatient and outpatient services.
• Pre-register patients via phone or department protocol.
• Enter referral and authorization data into Epic accurately and timely.
• Educate patients about the managed care process and financial responsibilities.
• Support quality improvement initiatives and adhere to patient privacy policies (HIPAA).

Skills

Organizational skills

Analytical skills

Prioritization skills

Communication skills

Interpersonal skills

Education

High School diploma or GED

Tools

Epic (EHR) system

Windows OS

Job description

Children's Wisconsin seeks a Financial Verification Representative to initiate precertification and authorizations for inpatient and outpatient services, verify insurance, and ensure smooth billing flow. The role involves patient pre-registration and entering authorization data into Epic with accuracy and timeliness, while educating families on the managed care process.

Strong organizational, analytical, and communication skills are required to handle multiple tasks in a fast-paced healthcare