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Froedtert Health
PRE-AUTHORIZATION SPECIALIST, FCH - ENTERPRISE REGISTRATION
Career Insights for Medical Claims Processor / Representative
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What they do
A Medical Claims Processor or Representative reviews and processes medical insurance claims and determines whether an insurance policy will cover a medical procedure. Gathers information from policy holders and organizes insurance files; may process checks with payments to policy holders when a medical claim is approved.
$41,619 / year median in the U.S.
-11% projected decline
Job Description
Discover. Achieve. Succeed. #
BeHere Location:
US:
WI:
MENOMONEE FALLS
at ourWOODLAND PRIME 400
facility. This job isREMOTE. FTE
1.000000Standard Hours:
40.00Shift:
Shift 1Job Summary:
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.EXPERIENCE DESCRIPTION
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. Prior experience in a business office position with strong customer service background preferred.EDUCATION DESCRIPTION
High School diploma or equivalent is required.SPECIAL SKILLS DESCRIPTION
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. Compensation, Benefits & Perks at Froedtert Health Pay is expected to be between: (expressed as hourly) $21.16- $28.78. Final compensation is based on experience and will be discussed with you by the recruiter during the interview process. Froedtert Health Offers a variety of perks & benefits to staff, depending on your role you may be eligible for the following: 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 The Froedtert & the Medical College of Wisconsin regional health network is a partnership between Froedtert Health and the Medical College of Wisconsin supporting a shared mission of patient care, innovation, medical research and education.