The Neuroscience Group has an opening for a full-time Medical Insurance Authorization Specialist on our Patient Services Team. As an integral member of the Clinical Services Team, the Patient Services Representative is responsible for pre-authorizing ancillary testing and treatment (including surgery) conducted in the Neuroscience Group office and outside the office setting. This position includes verification of insurance benefits as it applies to the precertification process and obtaining precertification/preauthorization from payors.

 

RESPONSIBILITIES:

  • Supports and promotes the mission and strategic vision of the organization
  • Supports and promotes the Ideal Patient Experience and Brand Building Basics
  • Collects and reviews all patient insurance information and submits prior-authorization form.
  • Determines necessity for pre-authorization and obtains authorization of ancillary tests (CT, MRI, EEG, EMG, Sleep Studies), treatment and/or procedure(s) conducted in the Neuroscience Group office and outside locations.
  • Upon receiving the anticipated procedure codes from the Provider, verifies insurance coverage, obtains preauthorization, and communicates with the involved parties regarding benefit eligibility and other financial issues.
  • Notifies patients and practitioners of any services requested and/or referred that are not authorized by insurance.
  • Informs patient of referral status in relationship to ancillary procedures(s)/testing.
  • Maintains good communication with the patient, physician, clinical services team, reimbursement services team, surgical and hospital staff.
  • Maintains timely, complete documentation and recordkeeping to ensure accurate continuity of patient care.
  • Regularly attends all team and staff meetings.
  • All other temporary and/or permanent duties as assigned by the Team Leader of Patient Services Representative.

KNOWLEDGE/SKILLS PREFERRED TO BE SUCCESSFUL IN THIS POSITION:

  • Previous experience in preauthorization/precertification and processing of health insurance claims.
  • Knowledge of insurance and third party payers.
  • Previous experience with CPT and ICD-10 coding.
  • Prior EPIC experience.

KNOWLEDGE/SKILLS REQUIRED TO BE SUCCESSFUL IN THIS POSITION:

  • Previous experience in preauthorization/precertification and processing of health insurance claims.
  • Knowledge of insurance and third party payers.
  • Previous experience with CPT and ICD-10 coding.
  • Prior EPIC experience.
  • Basic computer knowledge and keyboarding skills
  • Medical terminology
  • Excellent communication skills
  • Customer service experience
  • Strong organizational skills
  • Detail-oriented
  • Ability to multi-task and work well in a fast-paced setting
  • Critical thinking skills and decisive judgment

Location: 1305 West American Drive, Neenah, WI 54956

Compensation: We offer a highly competitive salary and benefit package; typically no holidays or weekends.

Contact: Manager of Human Resources
1305 W. American Drive
Neenah, WI 54956
mary.bellile@neurosciencegroup.com
Fax: 920-729-1334
Hours: 8:00 a.m. to 5:00 p.m., Monday-Thursday and 3:30 p.m. Friday

Application for Employment