Prior Authorization Specialist - East Mason

Prevea Health
United States, Wisconsin, Green Bay
Sep 19, 2024
Prior Authorization Specialist Come work where we specialize in you! We have nearly 2,000 reasons for you to consider a career with Prevea Health-they're our employees. We're an organization that values kindness, responsibility, inclusivity, wellness and inspiration. At Prevea, we provide continuous education, training and support so every member of the team contributes to our success. Together we are the best place to get care and the best place to give care. Job Summary Providing exceptional care for our patients as well as recognizing the value of your co-workers is the expectation of all members of the Prevea Health organization. All members are expected to focus on the patient's needs; relate to all in a friendly, accepting manner; communicate in a positive and professional way to patients and co workers; use time effectively and efficiently; and demonstrate an overall high level of performance. What you will do Works closely with department physicians and staff, coding and billing staff, to ensure understanding of information needed to obtain proper authorization for payment. Communicates with patients prior to specialty consultation or surgical procedure to provide them with information regarding their coverage. Identifies what is required for Preauthorization of surgical procedures and completes the process to minimize denial of claims. Preauthorization documentation. Communicate with hospitals and patient on progress/approval of Preauthorization. Education Qualifications High School Diploma and/or GED Required Experience Qualifications 1-3 years One year of experience in a medical or insurance role Preferred Skills and Abilities General computer knowledge needed to navigate electronic medical record and for documentation. Excellent organizational skills. Excellent communication skills and follow through with internal and external customers. Knowledge of insurance and medical terminology. Knowledge of CPT/ICD-9 coding useful. Physical Demands Sit - Constantly Stand - Rarely Walk - Rarely Drive - Rarely Climb (Stairs/Ladders) - Rarely Bend (Neck) - Frequently Gross Manipulation (Hands/Arms) - Constantly Squat - Rarely Twist/Turn (Neck) - Occasionally Lift/Carry 0-10 lbs. - Rarely Lift/Carry 11-25 lbs. - Rarely Lift/Carry 26-35 lbs. - Rarely Push/Pull up to 10 lbs. - Rarely Push/Pull 11-25 lbs. - Rarely Push/Pull 26-35 lbs. - Rarely Reach (Above shoulder level) - Rarely Reach (Below shoulder level) - Constantly Simple Grasping (Hands/Arms) - Constantly Fine Manipulation (Hands/Arms) - Constantly Gross Manipulation (Hands/Arms) - Constantly Working Conditions Noise - Occasionally Hearing Requirements Hears Whispers < 3 feet - Constantly Hears Whispers 3-8 feet - Constantly Vision Requirements Color Discrimination - Constantly Near Vision (Correctable to Jaeger 2 or 20/30 binocular) - Constantly Distance Vision (Correctable to Snellen chart 20/30 binocular) - Constantly Prevea is an Equal Employment Opportunity/Affirmative Action employer. In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United State and to complete the required employment eligibility document form upon hire. Prevea participates in E-verify. To learn more about E-Verify, including your rights and responsibilities, please visit www.dhs.gov/E-Verify Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled