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Pre-Authorization Specialist

Company Froedtert
Location Menomonee Falls, WI 53051
Update 6 Day ago
300
Come join our award winning team! See What Is Possible….

The Froedtert & the Medical College of Wisconsin regional health care network is composed of an academic medical center, two community hospitals and more than 25 primary and specialty care health centers and clinics. The Froedtert & MCW health network offers exceptional care in the community and streamlined, coordinated access to specialty expertise, clinical trials and the full range of tertiary care capabilities of eastern Wisconsin’s only academic medical center when the need for more complex treatment arises.

Froedtert Health has been widely recognized for our dedication to our staff, providing a work environment full of encouragement, innovation, collaboration and respect.

We are honored to be recognized in the Milwaukee Journal Sentinel as a Top Workplace by WorkplaceDynamics for five consecutive years. Our best-in-class wellness program has earned us recognition in the Milwaukee Business Journal as a Healthiest Employer and a Gold Well Workplace award from the Wellness Council of America.

We invite you to review the job posting below. If you meet the requirements and qualifications for this opportunity, you are encouraged to apply.

Thank you for considering a career with Froedtert Health!

Location: US: WI: MENOMONEE FALLS at our WOODLAND PRIME 200 facility.

FTE: 1.000000

  • 1.0 FTE is Full-Time, any position less than 1.0 FTE is Part-Time, and .001 FTE is Optional Part-Time*
  • Positions with an "FTE" (full time equivalency) of .875 - 1.0 are eligible for full-time medical, dental and vision benefits. Positions with an "FTE" of .5 - .874 are eligible for part-time pro-rated medical, dental and vision benefits*
Shift: 1 Monday-Friday 8-430 or 830-5 pm

Responsibilities:
The Pre-Authorization Specialist is a member of the Pre-Authorization Department who is responsible for verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to the delivery of inpatient, outpatient, and ancillary services. This individual determines which patient services have third party payer requirements and is responsible for obtaining the necessary authorizations for care. The Pre-Authorization Specialist provides detailed and timely communication to both payers and clinical partners in order to facilitate compliance with payer contractual requirements and is responsible for documenting the appropriate information in the patient's record. Other duties as assigned.

Summary:
Minimum of two years experience in hospital billing/pre-authorization or insurance verification with demonstrated knowledge of health insurance plans including: Medicare, Medicaid, HMO's and PPO's required. Prior experience in a business office position with strong customer service background preferred.

High School diploma.

Other information:
Exceptional customer relations skills required. Knowledge of online insurance eligibility systems. Excellent typing and computer skills. Familiarity with Medical Terminology. Demonstrated ability to efficiently organize work and maintain a high level of accuracy and productivity.

We are proud to be an Equal Opportunity Employer who values and maintains an environment that attracts, recruits, engages and retains a diverse workforce. As a federal contractor/subcontractor, we take affirmative action in employment based on race, sex, disability and status as a protected veteran. We welcome protected veterans to share their priority consideration status with us at 262-439-1961. We maintain a drug-free workplace and perform pre-employment substance abuse testing