Member Certification Specialist jobs in Appleton, WI

We are looking to add someone to our team who can work in a fast-paced environment with great customer service, has great attention to detail, and can quickly adapt to change throughout the day. If you have medical insurance and prior authorization experience who promotes positivity, this position is for you.

ABOUT BONE & JOINT

Bone & Joint is a physician owned practice with a great team of orthopedic and PM&R providers. We currently have offices in Rib Mountain, Wausau, Merrill, Medford, and Plover to service much of Central Wisconsin. Bone & Joint strives to be the best place for patients to receive care, the best place for providers to practice, and the best place for employees to work.

A DAY IN THE LIFE OF A PRE-CERTIFICATION SPECIALIST

Being a part of the Pre-Certification/VOB team you will complete a variety of tasks each day in a very fast-paced environment. Our Pre-Certification team works with several different departments throughout Bone & Joint. You will work and communicate daily with our Providers, their clinical teams, Ambulatory Surgery Center teams, Registration, coding & billing team, Therapy teams along with outside companies such as Insurance carriers, and other outside hospital systems. Primarily you will be completing insurance prior authorizations via online or over the phone for procedures, surgery, High end imaging, DME, etc. that our ordered by our providers. We also complete verification of benefits for all patients to ensure they have active coverage and a plan that Bone & Joint accepts at our clinics and Walk-in locations.

QUALIFICATIONS FOR A PRE-CERTIFICATION SPECIALIST

• High school diploma or equivalent

• Valid Driver's License

• Patience and ability to work with people at all levels, internal and external, required.

• Must have great attention to detail.

• 1 plus years' experience with online and telephone prior authorizations for services.

• Experience and knowledge of all types of insurances (government, commercial, programs, private).

WORK SCHEDULE

This position is working M-F at our Wausau, Westwood location with hours varying between 6:30am - 5pm.

READY TO JOIN OUR TEAM?

If you think you have what it takes to do this job, then the next step is to fill out our online application. Don't worry, the application is pretty simple as it asks for your resume and to answer some questions to help us get to know you better. We should warn you though, if you are selected to move forward in the hiring process, we will require that you provide us with further details to help us further understand your interest.