Precertification & Insurance Verification Specialist

Children's Wisconsin; West Allis (WI); On-site; USD 21,000 - 30,000; Full time

Job summary

Children’s Wisconsin is seeking a Financial Verification Representative to initiate precertification and authorizations for inpatient and outpatient services. The role involves contacting insurers and families to obtain referrals, and entering data into the Epic system to ensure smooth billing processes.

Candidates should have a high school diploma and 2+ years in registration or administrative support in healthcare or a related field, with preference for Epic experience.

Qualifications

• Excellent organizational, analytical, and prioritizing skills necessary to work in a fast-paced environment with multiple tasks.
• Excellent communication and interpersonal skills necessary to gather and share information with families, and team members in a courteous, professional and confidential manner.

Responsibilities

• Initiates precertification and authorizations online, phone or written documentation for all day surgeries, radiology procedures, therapies, psychiatry services, and other outpatient services as defined by payer specific requirements
• Contacts insurance companies, primary care physicians, and patient families to secure referrals for patient that have out of network insurances.
• Enters referral, and precertification/prior authorization information into Epic both timely and accurately.
• Helps educate patient/guardian/parent about the managed care process and means of obtaining valid referrals and authorizations
• Participates in quality improvement initiatives, training sessions, and department meetings.

Skills

Organization

Communication

Analytical

Education

High School diploma or GED

Job description

Children’s Wisconsin is seeking a Financial Verification Representative to initiate precertification and authorizations for inpatient and outpatient services. The role involves contacting insurers and families to obtain referrals, and entering data into the Epic system to ensure smooth billing processes.

Candidates should have a high school diploma and 2+ years in registration or administrative support in healthcare or a related field, with preference for Epic experience.