Prior Authorization Specialist - Remote

Overview

St. Croix Health is looking for a full-time Prior Authorization Specialist to join our Business Office team, responsible for coordinating and monitoring the day-to-day operational activities of verifying insurance benefits.

In Short

• Full-time position working Monday - Friday, day hours.
• Training will take place on-site in St. Croix Falls, Wisconsin.
• Remote work considered once fully trained.
• Responsible for obtaining precertification/preauthorization from payers.
• Communicates with insurance companies for the prior authorization process.
• Maintains relationships with payer groups.
• Documents necessary information in Epic.
• Responds to patient concerns and questions.
• Minimum 3 years of Medical Customer Service experience required.
• Knowledge of CPT and ICD-10 coding is required.

Requirements

• High School diploma/GED.
• 3+ years of Medical Customer Service or 2+ years in healthcare with insurance experience.
• Previous experience with insurance and third-party payers preferred.
• Formal coursework in medical terminology required.
• Prior recent EPIC/Excellian experience preferred.
• Excellent communication and listening skills.
• Ability to work independently and manage multiple demands.

Benefits

• Health, vision, and dental insurance.
• 403b retirement program with employer match.
• Paid time off.
• Short-term and long-term disability insurance options.
• Education reimbursement.
• Employee assistance program (EAP).
• Wellbeing incentive program.
• Free parking.
• Employee prescription discount program.