INSURANCE VERIFICATION SPEC, FCH - ENTERPRISE REGISTRATION

Froedtert

Posted 3 months ago

Full Time

Menomonee Falls, Wisconsin

Remote OK

Smart Summary

Responsibilities

Responsible for verifying insurance eligibility and obtaining necessary pre-certifications and authorizations prior to patient services. Collaborates with clinical partners and payers to ensure compliance with contractual requirements and documents all information in patient records.

Qualifications

You have a High School diploma or equivalent and at least one year of experience in a hospital admitting, registration, billing, or managed care department. You possess knowledge of health insurance plans, online eligibility systems, and medical terminology, along with strong typing and computer skills for accurate documentation.

Must Have Skills for ATS

Medicare

Medicaid

HMOs

PPOs

Medical Terminology

online insurance eligibility systems

Job Description

Discover. Achieve. Succeed. #BeHere

Location: US:WI:MENOMONEE FALLS at our WOODLAND PRIME 400 facility.

This job is REMOTE.

FTE: 1.000000

Standard Hours: 40.00

Shift: Shift 1

Shift Details: M-F 8-430 CST.

Job Summary:

The Insurance Verification Specialist is a member of the Pre-Authorization Department who is responsible for verifying eligibility, obtaining insurance benefits, and ensuring pre-certification, authorization, and referral requirements are met prior to delivery of inpatient, outpatient, and ancillary services. This individual determines which patient services have third party payer authorization requirements and collaborates with the appropriate clinical partners, case managers, financial counselors, payers, and others to make sure the necessary authorization is obtained. The Insurance Verification Specialist provides detailed and timely communication in order to facilitate compliance with payer contractual requirements and is responsible for documenting the appropriate information in the patient's record. Other duties as assigned.

EXPERIENCE DESCRIPTION:

Minimum of one year experience in a hospital admitting/registration/billing/managed care department with demonstrated knowledge of health insurance plans including: Medicare, Medicaid, HMO's, and PPOs.

EDUCATION DESCRIPTION:

High School diploma or equivalent is required.

SPECIAL SKILLS DESCRIPTION:

Knowledge of online insurance eligibility systems. Excellent typing and computer skills. Familiarity with Medical Terminology. Demonstrated ability to efficiently organize work and maintain a high level of accuracy and productivity.


Compensation, Benefits & Perks at Froedtert Health

Pay is expected to be between: (expressed as hourly) $20.45- $27.81. Final compensation is based on experience and will be discussed with you by the recruiter during the interview process.

Froedtert Health Offers a variety of perks & benefits to staff, depending on your role you may be eligible for the following:

  • Paid time off
  • Growth opportunity- Career Pathways & Career Tuition Assistance, CEU opportunities
  • Academic Partnership with the Medical College of Wisconsin
  • Referral bonuses
  • Retirement plan - 403b
  • Medical, Dental, Vision, Life Insurance, Short & Long Term Disability, Free Workplace Clinics
  • Employee Assistance Programs, Adoption Assistance, Healthy Contributions, Care@Work, Moving Assistance, Discounts on gym memberships, travel and other work life benefits available

The Froedtert & the Medical College of Wisconsin regional health network is a partnership between Froedtert Health and the Medical College of Wisconsin supporting a shared mission of patient care, innovation, medical research and education. Our health network operates eastern Wisconsin's only academic medical center and adult Level I Trauma center engaged in thousands of clinical trials and studies. The Froedtert & MCW health network, which includes ten hospitals, nearly 2,000 physicians and more than 45 health centers and clinics draw patients from throughout the Midwest and the nation.

We are proud to be an Equal Opportunity Employer who values and maintains an environment that attracts, recruits, engages and retains a diverse workforce. We welcome protected veterans to share their priority consideration status with us at 262-439-1961. We maintain a drug-free workplace and perform pre-employment substance abuse testing. During your application and interview process, if you have a need that requires an accommodation, please contact us at 262-439-1961. We will attempt to fulfill all reasonable accommodation requests.

Froedtert

The Froedtert & the Medical College of Wisconsin health network is a partnership between Froedtert Health and the Medical College of Wisconsin supporting a shared mission of patient care, innovation, medical research and education. Our health network operates eastern Wisconsin's only academic medical center and adult Level I Trauma Center at Froedtert Hospital, Milwaukee, an internationally recognized training and research center engaged in thousands of clinical trials and studies. The Froedtert & MCW health network, which includes 10 hospital locations, more than 2,300 physicians and more than 45 health centers and clinics, draws patients from throughout the Midwest and the nation. In our most recent fiscal year, outpatient visits were more than 1.6 million, inpatient admissions to our hospitals exceeded 57,500 and visits to our network physicians totaled more than 1.28 million. In addition to Froedtert Hospital, the network includes Froedtert Bluemound Rehabilitation Hospital, Froedtert Holy Family Memorial Hospital, Froedtert Menomonee Falls Hospital, Froedtert West Bend Hospital and Froedtert Community Hospital with locations in Mequon, New Berlin, Oak Creek and Pewaukee. The health network represents the collaboration of Wisconsin’s largest multispecialty physician practice with two community-based physician groups. In 2017, an existing affiliation with the former United Hospital System was expanded to include what is now known as Froedtert Pleasant Prairie Hospital and related clinics in the network. In 2024, Froedtert Health and ThedaCare became one organization, making it possible for the health network to enhance access to care for more people in Wisconsin.
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