Preauthorization and Referral Assistant

Beloit Health System is looking to add a Preauthorization & Referral Assistant to our Insurance & Billing team!

• Shift: First
• Schedule:
  
  8a – 4:30p
• Hours per week: 40
• Benefits Status:
  Eligible
• Department:
  
  Beloit Clinic Insurance/Billing

• Promptly responds to inquiries and requests for assistance from providers, staff, patients, payers, and/or employers via telephone, by mail, or in person.
• Obtains and verifies pertinent medical information and insurance information via the billing/medical record system .Assist sprovider with prior authorization/referral of drugs, including contacting Payers, patient, completing forms and keeps provider updated during this process.
• Contacts patient Payer(s) regarding preauthorization and/or second opinion requirements prior to procedures, hospital admissions, and tests to assure reimbursement for charges incurred for these services.
• Reviews daily hospital .schedules to confirm that all required preauthorization have been completed and notifies provider appropriately..
• Documents pertinent details in the Practice Management System.
• Uses work queues to identify and work claims in various states of transmission and ensures they are worked in a timely manner.
• Maintains a working knowledge of Payer rules.
• Utilizes available Payer websites to complete authorizations and referrals. Demonstrates ability to perform functions accurately and efficiently with computer software
• Interacts in a positive, responsible and cooperative manner with patients, Providers, co-workers and managers.

• High School graduate or equivalent. Initiative and sound judgment.
• Excellent organizational, verbal communication and interpersonal relation skills to be utilized with providers, patients, public staff and payers.
• Must have knowledge of medical terminology, previous insurance experience, or Medical Assistant experience.
• Excellent computer skills, with MS Word and Excel preferred.
• Must adhere to established regulatory agencies, Beloit Health System, and department policies, rules and regulations.
• Maintain ethical conduct and keep confidential personal, financial and medical information about patients
• Reporting Relationship:
  Director of Revenue Cycle.