Pre-Verification Specialist Details

Pre-Verification Specialist

BayCare Clinic - Manitowoc, WI

Employment Type : Full-Time

Join our Orthopedics team in Manitowoc as a Pre-verification Specialist! This role provides assistance to the clinic by working with patients, insurers, and providers. Ensures that necessary requirements are met in order to receive authorization that payment will be made for various medical procedures.

This position is full time, Monday - Friday between the clinic hours of 8-5. No nights, weekends or holidays!

Essential Functions:

• Pre-certify procedures/injections with insurance companies via phone or internet, or fax
• Work as a liaison between patient, physician, and hospital regarding insurance pre-certification, pre-authorization, and/or any other insurance issues
• Utilize SecuReach/EPIC to document and communicate authorizations, results, etc.
• Document all information in EPIC
• Complete appropriate disability and medical leave paperwork for patients.
• Other administrative duties as assigned
• Respects and maintains confidentiality.
• Works in a safe, compliant and ethical manner at all times.

• AAS in Health Care Business or combination of education and experience preferred.
• Typically requires two years experience with patients and providers in clinic, hospital or health insurance setting.
• Knowledge of medical terminology and the insurance verification process required.
• Excellent organizational, interpersonal and communication skills are necessary.
• Strong computer skills required.