Medical Insurance Verification Specialist at ORTHOPAEDIC ASSOCIATES OF WISCONSIN – Pewaukee, Wisconsin

Work Where There is a Difference—Excellence in Patient Care at Every Level
For over 40 years, Orthopaedic Associates of Wisconsin (OAW) has been the state’s premier orthopedic practice, delivering exceptional care through innovation and expertise. Our team includes highly skilled orthopedic surgeons and dedicated health professionals—all working together at the forefront of surgical advancements, rehabilitation, and patient education. We believe that investing in our staff leads to better patient outcomes. At OAW, there is a difference.

Summary of Role
The Insurance Verification Specialist is responsible for ensuring insurance coverages are verified via insurance portals or phone. This includes working all internal emails sent showing insurance rejections, updating Epic with new/correct coverage, noting accounts and responding via email of completion of verification. Maintains high quality customer service standards in compliance with federal and state guidelines. Will perform other duties as assigned by management.
Key Responsibilities

• Use of payer websites or outbound calls to payers to verify the patient insurance coverage and identify available benefits.
• Contact insured patients or other involved parties to obtain missing information.
• Identify any payer coverage restrictions such as out of network and/or coverage with no out of network benefits.
• Communicate case details to appropriate internal parties once benefit verification is complete.
• Accurate and efficiently enter data of patient information and insurance details.
• Accurately documents insurance findings in patient account notes.
• Communicate with patients calling to make payments on account and processing of payments through credit card payment portal.
• Effectively multitask in a high volume, fast paced environment.
• Ability to work and contribute independently.
• Effectively meets time completion goals.
• Participate in and complete special projects and perform additional duties as required.
• Maintains high quality customer service standards in compliance with federal and state guidelines.

An individual in this position must be able to perform the essential duties and responsibilities listed above successfully. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions of this position.The above list reflects the general details necessary to describe the principle and essential functions of the position and shall not be construed as the only duties that may be assigned for the position.

Education

• High School Diploma or equivalent

Required

• Three or more years of experience in healthcare billing.
• Experience using EPIC, Microsoft Office, and Payer Portal.
• Must be able to maintain a professional attitude and confidentiality.
• Strong oral, written communication, and time management skills
• Ability to work in a team environment
• Ability to multitask in a high volume, fast paced working environment.

Preferred

• Familiarity with commercial insurance guidelines and medical terminology
• Background in healthcare is a plus!

Work Environment

Shifts are Monday - Friday between 7:30 AM – 5:00 PM. This position will report to the OAW Pewaukee Clinic and will eventually have the flexibility to be remote.

Your Next Career Move Starts Here!

Apply now and join a highly respected orthopedic practice where your skills make a difference.

Equal Employment Opportunity

OAW provides equal employment opportunity to all applicants and employees. OAW disapproves of, and will not tolerate, unlawful discrimination against any applicant or employee because of race, color, national origin or ancestry, gender (including pregnancy, childbirth, or related medical conditions), gender identity, age, religion, disability, family care status, veteran status, marital status, sexual orientation, or any other basis protected by local, state, or federal laws.