Insurance Authorization Specialist

4 weeks ago


West Allis, Wisconsin, United States Advocate Health Full time
Job Summary

We are seeking a highly skilled Insurance Authorization Representative to join our team at Advocate Health. As a key member of our team, you will be responsible for ensuring that patients receive the necessary authorizations and pre-certifications for their medical treatments.

Key Responsibilities
  • Obtain and verify patient information, including insurance coverage and eligibility.
  • Communicate with insurance carriers to obtain benefit coverage, policy limitations, and authorization/notification.
  • Collaborate with internal departments to provide account status updates and coordinate the resolution of issues.
  • Educate patients, staff, and providers on referral and authorization requirements, payer coverage, and eligibility guidelines.
  • Ensure all services have prior authorizations and update patients on their pre-authorization status.
  • Notify patient accounts staff and patients of insurance coverage lapses and self-pay patient status.
Requirements
  • High School Graduate or equivalent.
  • Typically requires 1 year of experience in providing customer service, including experiences in patient accounts, third-party payer plans, accounts receivable/collection processes, and medical clinic processes and workflow.
  • Knowledge of third-party payers and pre-authorization requirements.
  • Intermediate computer skills, including use of Microsoft Office, electronic mail, physician practice management, and electronic medical records systems.
  • Strong analytical, prioritization, and organizational skills.
  • Exceptional communication and interpersonal skills with a high degree of diplomacy and tact.
Working Conditions

This is a per diem/casual opportunity with a first week in-office training commitment.



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