Clinical Authorization Specialist

4 weeks ago

Middleton, United States University of Wisconsin Hospitals and Clinics Authority Full time
Work Schedule :

100% FTE. Scheduled shifts are 8:30 am - 5:00 pm, Monday - Friday. Hours may vary based on the operational needs of the department. This is a hybrid remote position.

Be part of something remarkable

Join the #1 hospital in Wisconsin

We are seeking a Clinical Authorization Specialist:

  • Confirm the need for authorizations by taking the appropriate actions to ensure authorizations are obtained; this includes acting as a liaison between insurance companies, healthcare providers and patients in coordinating the prior authorization of surgeries performed at performed at University Hospital, East Madison Hospital, Madison Surgery Center and UnityPoint Health - Meriter.
  • Medical policy review to ensure scheduled procedures will meet medical necessity guidelines set forth by insurance payers.
  • Coordinate with, educate and advise providers participating in a patient's care regarding complex or high-risk admissions, or any episode of service requiring additional attention.

Education :

Minimum - High School diploma or equivalent and completion of a Medical Assistant program, coding program or licensure as an LPN.

Preferred - Graduate of School of Nursing.

Our Commitment to Diversity, Equity, and Inclusion

UW Health is committed to being a diverse, equitable, inclusive and anti-racist workplace and is an Equal Employment Opportunity, Affirmative Action employer. Our integrity shines through in patient care interactions and our daily work practices as we work to embrace the knowledge, unique perspectives and qualities each employee and faculty member brings to work each day. Applications from Black, Indigenous and People of Color (BIPOC) individuals, LGBTQ+ and non-binary identities, women, persons with disabilities, military service members and veterans are strongly encouraged. EOE, including disability/veterans.

UW Health Administrative Facilities - UW Health has administrative locations throughout Madison and beyond where thousands of employees provide vital support to our clinical areas. These locations are home to departments such as Access Services, Compliance, Human Resources, Information Services, Patient Medical Records, Payroll and many others.

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