Prior Authorization/Referral Specialist in Kenosha, Wisconsin at Froedtert South, Inc.

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
  • Competitive PTO