Authorization Representative

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Full-time Regular Middleton, WI, US

5 days ago Requisition

Position Summary: The Billing Continuity Representative is responsible for obtaining initial and/or renewal authorizations, performing insurance verification and follow-up. This position also monitors and works with patients regarding compliance for insurance coverage. Serves as communication liaison between team members, third party payers, patients, and billing for financial arrangements.

Remote work after successful completion of training is an option! You must come onsite once quarterly after onsite training is completed. Must live within 2 hours driving distance to our location in Middleton. We provide the equipment to do your job from home! We offer competitive benefits; PTO is accrued from the day you start offering 3+ weeks a year!

Essential Job Knowledge:

• Obtains all renewal authorizations as well as initial authorizations that are needed after dispensing.
• Obtains all convert to purchase authorizations, follows up on all rentals compliance for convert to purchase, and renewal prescriptions.
• Communicates with patients via phone calls and letters explaining their state of compliance and their responsibility to become compliant.
• Answers questions regarding insurance coverage of services.
• Checking insurance eligibility and verifying qualifications needed for all insurance changes.
• Monitors and forwards any documentation requested by payers for reimbursement purposes.
• Reviews monthly Brightree report which identifies patients that have insurance changes or will be eligible for Medicare benefits based on their age.
• Is familiar with legislation that impacts the delivery of and billing of services.
• Reviewing and completing all WIPS and Tasks as assigned to Billing Continuity team and individual members.
• Follows procedures to monitor Medicare and Medicaid rules and regulations to assure appropriate and optimum reimbursement.
• Attends workshops, meetings, and seminars to keep the department abreast of the changes in legislation, regulations, and industry practices.
• Provides peer review input on selected employee performance reviews.
• Successfully completes initial and ongoing organizational and department education, training, and competency requirements.
• Infection Control:
  Understands, demonstrates, and follows organizational infection control guidelines (CDIC).
• Quality:
  Focuses on improving processes and champions efficiency in daily work activities.
• Safety:
  Promotes a culture of safety by taking accountability for individual actions, including but not limited to, promptly reporting errors or near misses via the organization’s occurrence reporting system and participating in developing improved safety processes, as appropriate. (ADM
  015, ADM
  016, OPS
  044, Mission Statement).
• Assures the federally required documents are obtained and maintained in a complete and timely manner.
• Performs other duties as assigned.

Benefits Include:

• Health,Dental, and Vision coverage
  - Competitive premiums!
• 401K matching - we match 100% on the first 3% you contribute and then match 50% on the next 2% you contribute!
• Employee Assistance Program - A great resource when facing different situations in life! Confidential!
• PTO
  - Generous PTO! 8.92 hours accrued biweekly for a fulltime position (80 hours per pay period)
• Flex Spending Account
• Dependent Care
• Short Term Disability
  - Employer Paid!
• Long Term Disability
  - Employer Paid!
• Basic Life Insurance &AD&D
  - Employer Paid!
• Voluntary Life Insurance
• Benefits take effect the first day of the following month you are hired! 401k eligibility starts one month after all…