Note: The job is a remote job and is open to candidates in USA. Froedtert Health is a regional health network that includes ten hospitals and nearly 2,000 physicians. The Pre-Authorization Specialist is responsible for verifying eligibility, obtaining insurance benefits, and ensuring pre-certification and authorization requirements are met prior to service delivery.
Responsibilities
• 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
• Determining which patient services have third party payer requirements and obtaining the necessary authorizations for care
• Providing detailed and timely communication to both payers and clinical partners to facilitate compliance with payer contractual requirements
• Documenting the appropriate information in the patient's record
• Other duties as assigned
Skills
• A minimum of 2 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
• High School diploma or equivalent is required
• 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
• Prior experience in a business office position with strong customer service background preferred
Benefits
• Paid time off
• Growth opportunity- Career Pathways & Career Tuition Assistance, CEU opportunities
• Academic Partnership with the Medical College of Wisconsin
• Referral bonuses
• Retirement plan - 403b
• Medical, Dental, Vision, Life Insurance, Short & Long Term Disability, Free Workplace Clinics
• Employee Assistance Programs, Adoption Assistance, Healthy Contributions, Care@Work, Moving Assistance, Discounts on gym memberships, travel and other work life benefits available
Company Overview
• Froedtert Health is a health system that provides cost-effective health care to residents in Wisconsin. It was founded in 1980, and is headquartered in Milwaukee, Wisconsin, USA, with a workforce of 10001+ employees. Its website is http://www.froedtert.com.
Company H1B Sponsorship
• Froedtert Health has a track record of offering H1B sponsorships, with 3 in 2024, 6 in 2023, 6 in 2022, 2 in 2020. Please note that this does not guarantee sponsorship for this specific role.