Insurance Authorization Specialist

Insurance Authorization Specialist

The Insurance Authorization Specialist performs insurance authorization for patients scheduled for services at ThedaCare by obtaining and validating demographic and insurance information. Works with insurance companies and/or physician offices to complete insurance authorization requirements.

Job Description:

Key Accountabilities:

• Selects accurate medical records for patient safety.
• Obtains and validates demographic and insurance information while working with insurance companies and/or physician offices to complete insurance authorization requirements to secure payment.
• Utilizes quality auditing and reporting systems to ensure accounts are correct.
• Conducts audits of accounts and ensures forms are accurately and timely completed to meet audit standards and provide statistical data to leaders.
• Performs duties as assigned including answering the phones at other facilities.

Qualifications:

• High School diploma or GED preferred
• Must be 18 years of age

Physical Demands:

• Ability to move freely (standing, stooping, walking, bending, pushing and pulling) and lift up to a maximum of twenty-five (25) pounds without assistance
• Job classification is not exposed to blood borne pathogens (blood or bodily fluids) while performing job duties

Work Environment:

• Climate controlled office setting with daily movement throughout the facility
• Interaction with department members and other healthcare providers
• This position involves frequent phone communication with patients and staff. All inbound and outbound calls are recorded and monitored for quality assurance, training, and compliance purposes.

Scheduled Weekly Hours:

40

Scheduled FTE:

1

Location:

ThedaCare Corporate Office - Neenah, Wisconsin

Overtime Exempt:

No

Worker Shift Details:

Days