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Insurance Authorization Representative - WEST ALLIS, WI, United States - TEKsystems
Description
Our client is hiring an Insurance Authorization Representative to join their team onsite in West Allis, Wisconsin
Shift: 8am-4:30pm
Description: You will be working with an Excel spreadsheet to gather and transfer data to the UHC (United Healthcare) portal. Will be processing around 55/day. Responsibilities include but are not limited to:
Ensures information obtained is complete and accurate, applying acquired knowledge of Medicare, Medicaid and third party payer requirements/online eligibility systems
Contacts insurance carries to obtain benefit coverage, policy limitations, authorization/notification, and pre-certifications for patients
Follows up with physician office, financial counselors, patients and third party payers to complete pre-certification process
Collaborates with internal departments to provide account status updates, coordinate resolution of issues, and appeal denied authorizations
Educated patients, staff and providers regarding referral and authorization requirements, payer coverage, eligibility guidelines, documentation requirements and insurance related changes or trends
Ensures all services have prior authorizations and updates patients on their preauthorization status. Coordinates peer to peer review if required by insurance
Notifies patient accounts staff/patients of insurance coverage lapses, and self-pay patient status. May notify ordering providers if authorization/certification is denied.
May coordinate scheduling of patient appointments, diagnostic and/or specialty appointments, tests and/or procedures
Maintains files for referral and insurance information , and enters referrals into the system
Maintains knowledge of and reference materials of the following: Medicare, Medicaid and third-party payer requirements, guidelines and policies, insurance plans requiring pre-authorization and a list of current accepted insurance plans
Skills & Qualifications:
High school diploma
Proficient in Microsoft Excel
Experience with EPIC
Prior authorization experience required
Must have good attendance
About TEKsystems:
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
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