Insurance Authorization Specialist

4 weeks ago


West Allis, Wisconsin, United States Advocate Health Full time

Job Summary

As a key member of our team at Advocate Aurora Continuing Health, the Insurance Authorization Representative plays a vital role in ensuring seamless patient care. This position is responsible for maintaining, confirming, and securing referrals, authorizations, or pre-certifications required for patients to receive physician or medical services.

Key Responsibilities

  • Verify the accuracy and completeness of patient account information
  • Maintain a database of payer authorization requirements
  • Contact insurance carriers to obtain benefit coverage, policy limitations, authorization/notification, and pre-certifications for patients
  • Collaborate with internal departments to provide account status updates, coordinate the resolution of issues, and appeal denied authorizations
  • Educate patients, staff, and providers regarding referral and authorization requirements, payer coverage, eligibility guidelines, documentation requirements, and insurance-related changes or trends

Requirements

  • Typically requires 1 year of experience in providing customer service that includes 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
  • Understanding of basic human anatomy, medical terminology, and procedures for application in the patient referral/pre-certification/authorization processes

Working at Advocate Aurora Continuing Health

We are committed to providing high-quality patient care and excellent customer service. As an Insurance Authorization Representative, you will have the opportunity to work in a dynamic and supportive environment, collaborating with a team of professionals who share your passion for delivering exceptional patient care.



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