Top 2 Prior authorization specialist Jobs in Madison, Wi

Medical Equipment and Supply Specialist - Continuum of Care
SSM Health —Madison, WI
- Part-time
- Mid-level
- High school diploma or GED
- Children
- Paid parental leave
- Parental leave
13d
Pharmacy Specialist
Quartz —Madison, WI
- $20.72 - $25.91 an hour
- Full-time
- Mid-level
- High school diploma or GED
- Criminal background check
- Opportunities for advancement

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Medical Equipment and Supply Specialist - Continuum of Care

SSM Health -
Madison, WI

Apply Now

Job Details

Part-time
13 days ago

Benefits

Paid parental leave
Parental leave

Qualifications

Collaborate with healthcare professionals
Health insurance co-pays
Overseeing health insurance pre-certification
Medicare
Mid-level
Patient service
High school diploma or GED
CMS regulatory compliance
Medicare regulations
Centers for Medicare and Medicaid Services (CMS)
Data entry
Medicaid regulations
Medicaid
Typing
Order processing
Ordering supplies
2 years
Documentation review
Documentation reviews
Financial compliance

Full Job Description

JOB DESCRIPTION

It's more than a career, it's a calling.

WI-SSM Health at Home Madison Hammersley

Worker Type:

Regular

Job Highlights:

Schedule: Monday–Friday, 8:30 AM – 5:00 PM

Job Summary:

Acts as a liaison between employees, providers, payers, customers, and other health care providers to obtain necessary documentation and process orders for medical equipment and supplies.

Job Responsibilities and Requirements:

PRIMARY RESPONSIBILTIES

Obtains and interprets medical documentation, compares documentation with insurance coverage criteria, and creates orders to provide medical equipment and supplies.
Verifies patient insurance eligibility/benefits and communicates financial responsibilities to patients, caregivers, and other health care providers.
Reviews, obtains, and logs appropriate medical documentation that supports the reimbursement of equipment/supplies.
Performs accurate data entry into operating system and processes orders for appropriate equipment/supplies to ensure delivery and correct billing.
Communicates with patients, employees, payers, caregivers, and other health care providers on status of orders.
Collects payments from patients for coinsurance, copays, and self-pay items.
Obtains written orders and prior authorization for appropriate equipment/supplies.
Ensures compliance with Medicare, Medicaid and Accreditation Standards.
Works in a constant state of alertness and safe manner.
Performs other duties as assigned.

EDUCATION

High School diploma/GED or 10 years of work experience

EXPERIENCE

Two years' experience

PHYSICAL REQUIREMENTS

Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.
Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements.
Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors.
Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc.
Frequent keyboard use/data entry.
Occasional bending, stooping, kneeling, squatting, twisting and gripping.
Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.
Rare climbing.

REQUIRED PROFESSIONAL LICENSE AND/OR CERTIFICATIONS

None

Department:

8055000174 Clinical Administration

Work Shift:

Day Shift (United States of America)

Scheduled Weekly Hours:

Benefits:

SSM Health values our exceptional employees by offering a comprehensive benefits package to fit their needs.

Paid Parental Leave: we offer eligible team members one week of paid parental leave for newborns or newly adopted children (pro-rated based on FTE).
Flexible Payment Options: our voluntary benefit offered through DailyPay offers eligible hourly team members instant access to their earned, unpaid base pay (fees may apply) before payday.
Upfront Tuition Coverage: we provide upfront tuition coverage through FlexPath Funded for eligible team members.

Explore All Benefits

SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status, or any other characteristic protected by applicable law. Click here to learn more.

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prior authorization specialist jobs in madison, wi

Medical Equipment and Supply Specialist - Continuum of Care

Pharmacy Specialist

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