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Insurance Claims / Policy Clerk
Kenosha, WI
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Prior Authorization/Referral Specialist Froedtert South, Inc. - 2.5 Kenosha, WI Job Details Full-time $17.00 - $25.25 an hour 1 day ago Benefits 403(b) matching Health insurance Dental insurance Tuition reimbursement Paid time off Vision insurance Employee discount 403(b) Qualifications Computer operation Customer communication Overseeing health insurance pre-certification Medical insurance coverage verification Customer service ICD-10 Healthcare referral management HCPCS Health insurance referral requirements Productivity software Patient registration Medical terminology Cross-functional communication Full Job Description A Pre-Authorization/Referral Specialist is responsible for determining insurance eligibility/benefits and ensuring pre-certification (authorization/referral) requirements are met for both the facility and professional services. The Pre-Authorization/Referral Specialist provides detailed documentation and communication with both payors and clinicians to obtain prior-authorizations. Obtains clinical information to support medical necessity. Knowledge, Skills & Abilities required: Experience in pre-authorization/referrals, patient registration, insurance verification and health insurance plans Knowledge of online insurance pre-authorization process and working with various payors Excellent computer and customer service skills Familiarity with Medical Terminology Demonstrated ability to efficiently organize work, while maintaining a high level of accuracy and productivity Knowledge of ICD-10, CPT and HCPC codes and use Familiarity with internet, email and Microsoft Office Effective written and verbal communication skills required
Salary Range:
$17.00 to $25.25/hr (based on experience)
Benefits:
Medical, dental and vision benefits available 403(b) company match available Tuition reimbursement Employee discount program