
INSURANCE VERIFICATION SPEC, FCH - ENTERPRISE REGISTRATION
Froedtert • Menomonee Falls, Wisconsin, United States
Role & seniority: Insurance Verification Specialist (entry to mid-level within Pre-Authorization, 1 FTE)
Stack/tools: Online insurance eligibility systems; basic hospital admitting/registration/billing workflows; medical terminology; strong typing/computer skills
Top 3 responsibilities
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Verify patient eligibility, obtain benefits, and confirm pre-certification/authorization/referral requirements before services
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Determine which services need payer authorization and coordinate with clinical partners, case managers, financial counselors, and payers to secure it
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Document required information in the patient record and communicate status to ensure payer contractual compliance
Must-have skills
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High school diploma or equivalent
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≥1 year hospital admitting/registration/billing/managed care experience
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Knowledge of Medicare, Medicaid, HMOs, and PPOs
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Proficiency with online insurance eligibility systems; excellent typing/computer skills
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Familiarity with medical terminology; ability to organize work with high accuracy and productivity
Nice-to-haves
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Experience interfacing with payers and obtaining authorizations
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Familiarity with electronic health record systems
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Location & work type: Location: Menomonee Falls, WI (Woodland Prime 400) + remote option; Full-time, 40 hours/week, Shift 1: Mon–Fri, 8:00 AM–4:30 PM CST
Full 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.