The Pre-Authorization Specialist is responsible for verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met before inpatient, outpatient, and ancillary services are delivered.
This role determines which patient services require third-party payer authorization and secures the needed approvals for care. The specialist also communicates with payers and clinical partners to support compliance with payer contractual requirements and documents appropriate information in the patient's record.
This position is remote and follows a Monday through Friday schedule, 8:00 AM to 4:30 PM CST.
Experience
- Minimum of 2 years of experience in hospital billing, pre-authorization, or insurance verification
- Demonstrated knowledge of health insurance plans, including Medicare, Medicaid, HMO, and PPO plans
- Prior business office experience with a strong customer service background preferred
Education
- High school diploma or equivalent required
Skills
- Exceptional customer relations skills
- Knowledge of online insurance eligibility systems
- Excellent typing and computer skills
- Familiarity with medical terminology
- Strong organizational skills with high accuracy and productivity
Compensation
- Hourly pay expected to be between $21.16 and $28.78
Benefits and Perks
- Paid time off
- Growth opportunities, career pathways, and tuition assistance
- CEU opportunities
- Academic partnership with the Medical College of Wisconsin
- Referral bonuses
- Retirement plan (403b)
- Medical, dental, vision, and life insurance
- Short- and long-term disability coverage
- Free workplace clinics
- Employee assistance programs
- Adoption assistance
- Healthy contributions
- Care@Work
- Moving assistance
- Discounts on gym memberships, travel, and other work-life benefits
Location
Wisconsin, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
Yes
Posted
1 month ago