Prior Authorization Specialist

Gundersen Health System; Wisconsin; Hybrid; USD 23,000 - 33,000; Full time

Benefits offered by this job

401(k) with matching

Paid time off

Health insurance

Wellness programs

Tuition reimbursement

Job summary

Gundersen Health System in Wisconsin is seeking a Prior Authorization Specialist to obtain pre-certifications and authorizations for services ordered from insurance. The role requires collaboration with hospital departments and insurers, with strong attention to detail and communication skills.

Full-time, 40 hours/week, in Onalaska, WI with remote eligibility after training. Experience in healthcare insurance and coding is a plus, supporting PT/OT services as needed.

Qualifications

• High School Diploma or equivalent.
• 1-2 years' experience in healthcare with insurance or prior authorization experience required.
• Excellent problem-solving abilities and strong attention to detail.
• Strong communication skills, both verbal and written.
• Coding experience and certifications is a plus!

Responsibilities

• Obtain pre-certifications and authorizations for services ordered by insurance.
• Collaborate with hospital departments and insurance companies to secure necessary approvals.
• Manage communications and documentation to ensure timely authorizations.
• Remote eligible after training; in-person in Onalaska, WI during training.

Skills

Attention to detail

Strong communication

Problem-solving

Education

High School Diploma or equivalent

Job description

Love + medicine is who we are, it's what we do, it's why people want to work here.

Scheduled Weekly Hours: 40

We’re not just filling positions, we’re building careers. At Emplify Health, we care for our teams, while they care for their communities. Whether you are just starting out or looking for a change, Emplify Health supports you now and into the future. Join us and find out how a little empathy changes everything.

We are looking for a Prior Authorization Specialist to join our team!

In this role you will work with hospital departments and insurance companies to obtain the necessary pre-certifications and authorizations for services ordered/scheduled from insurance. Attention to detail, strong communication, and computer and phone skills are important!

Job Specifics:

• Full time, 1.0 FTE
• 40 hours/week Monday-Friday, hours between 7 am -5 pm, 8-hour shifts
• Remote eligible after training in‑person in Onalaska, WI
• Specialize in prior authorization for Physical Therapy/Occupational Therapy

What You Need:

• High School Diploma or equivalency
• 1-2 years' experience in healthcare with insurance or prior authorization experience required
• Excellent problem-solving abilities and strong attention to detail
• Strong communication skills, both verbal and written
• Coding experience and certifications is a plus!

What You'll Get:

Starting pay of $20.31/hour + more for experience!

• Top-notch benefits: 401(k) with matching, paid time off, competitive health insurance, wellness programs to keep you and your family healthy, tuition reimbursement, and more
• Career Growth/CDC - Growth opportunities and access to Emplify Health’s Career Development Center to help you navigate your career

Emplify Health, a partnership of Bellin Health and Gundersen Health System, is a leading not-for-profit, patient-centered healthcare network based in Green Bay and La Crosse, Wisconsin. With 11 hospitals and over 100 clinics, we serve 67 cities across Wisconsin, Iowa, Minnesota, and Michigan's Upper Peninsula. Join us in making a meaningful difference in the lives of our patients and communities.

We inspire your best life by relentlessly caring, learning and innovating. This is our purpose. Together with our values — belonging, respect, excellence, accountability, teamwork and humility — our pillars set our foundation and our future.

Equal Opportunity Employer

Around here, loving your job is part of the job. Join our mission in changing healthcare while finding a career you’ll love!

What You Can Expect:

Empowerment to shape your work environment, encouragement to improve processes and create efficiencies, and support when seeking opportunities for growth. Culture that encourages self-care and provides you with opportunities to be your best self at work and at home. Competitive compensation and comprehensive benefits packages, as applicable, ensuring your comfort and well-being as a valuable team member. Support for your career growth through Professional Development Opportunities, our Tuition Investment Program, Career Development Center, and online continuing education courses.

Gundersen Health System, based in La Crosse, WI, is the leading provider of primary and specialized care in western Wisconsin, southeast Minnesota, and northeast Iowa; serving more than 500,000 residents throughout 22 counties. Our physician-led, not-for-profit healthcare system includes a 325-bed teaching hospital, tertiary referral center, and Level II Trauma Center; community clinics; 6 affiliate critical access hospitals; nursing homes; behavioral health services; vision centers; pharmacies; and air and ground ambulance services. Together, we inspire your best life by relentlessly caring, learning, and innovating.