Preauthorization Specialist
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Job Location:
Waterloo, WI - USA
Monthly Salary:
Not Disclosed
Posted on:
07-11-2025
Vacancies:
1 Vacancy
Job Summary
Overview
Preauthorization Specialist - Cardiology Center
UnityPoint Health - Allen
Shift: Monday - Friday Daytime
0.8 FTE 32 hours/week
Full-time Benefits
Obtains insurance eligibility benefits authorizations and pre-certifications for scheduled and non-scheduled visits and procedures performed at hospital. Updates demographic and insurance information in system as needed. Primary documentation source for access and billing staff. Resolve accounts on work queues. Interacts in a customer-focused and compassionate manner to ensure patients and their representatives needs are met. Assists in scheduling any non-invasive procedures and/or tests as directed.
Why UnityPoint Health
At UnityPoint Health you matter. Were proud to be recognized as a Top 150 Place to Work in Healthcare by Beckers Healthcare several years in a row for our commitment to our team members.
Our competitive Total Rewards program offers benefits options that align with your needs and priorities no matter what life stage youre in. Here are just a few:
- Expect paid time off parental leave 401K matching and an employee recognition program.
- Dental and health insurance paid holidays short and long-term disability and more. We even offer pet insurance for your four-legged family members.
- Early access to earned wages with Daily Pay tuition reimbursement to help further your career and adoption assistance to help you grow your family.
With a collective goal to champion a culture of belonging where everyone feels valued and respected we honor the ways people are unique and embrace what brings us together.
And we believe equipping you with support and development opportunities is a vital part of delivering an exceptional employment experience.
Find a fulfilling career and make a difference with UnityPoint Health.
Responsibilities
- Work with providers to assure that CPT and ICD-10 code is correct for procedure ordered and is authorized when necessary.
- Completes eligibility check and obtain benefits though electronic means or via phone contact with insurance carriers or other agencies and when necessary/requested provide initial clinical documentation.
- Initiates pre-certification process with physicians PHO sites or insurance companies and obtains pre-cert/authorization numbers and adds them to the electronic health record and other pertinent information that secures reimbursement of account.
- Perform follow-up calls as needed until verification/pre-certification process is complete.
- Thoroughly documents information and actions in all appropriate computer systems.
- Notifies and inform Utilization Review staff of authorization information to insure timely concurrent review.
- Validates or update insurance codes and priority for billing accuracy.
- Works with insurance companies to obtain retroactive authorization when not obtained at time of service.
Qualifications
Minimum Qualifications:
- High School or Vocational School graduate.
- Ability to demonstrate strong customer service skills.
- Ability to effectively enter information into a variety of computer programs.
- Ability to understand and apply guidelines policies and procedures.
- Ability to interact effectively with physicians health care team members individuals and members of their support systems.
- Ability to communicate effectively with people of diverse professional education and lifestyle backgrounds.
- Writes reads comprehends and speaks fluent English.
- Multicultural sensitivity.
- Microsoft Office basic computer skills.
- Customer/patient focused.
- Critical thinking skills using independent judgment in making decisions.
Preferred:
- Previous medical office experience preferred.
- Previous experience with an electronic health record or medical office software preferred.
- Previous experience coding diagnoses and procedures with ICD09-CM and CPT preferred.
- Knowledge of medical terminology anatomy and physiology.
Required Experience:
IC
Key Skills
- Sales Experience
- Crane
- Customer Service
- Communication skills
- Heavy Equipment Operation
- Microsoft Word
- Case Management
- OSHA
- Team Management
- Catheterization
- Microsoft Outlook Calendar
- EHS
About Company
As an integrated health system, we provide care throughout Iowa, western Illinois and southern Wisconsin in not-for-profit hospitals, clinics and home health settings.
