Referral & Prior Authorization Specialist
Join the REMARKABLE team at SwedishAmerican! As a division of UW Health, we offer patients local access to many world-class specialists right here in Rockford, Illinois and surrounding communities.
We are seeking a Referral & Prior Authorization Specialist to:
- Join our world-class team of doctors, nurses and other health care professionals in providing everything from preventive health care to highly specialized programs.
- Provide quality care in a compassionate patient- and family- centered environment.
- Be responsible for insurance verification, determining prior authorization requirements, obtaining referrals for outpatient services and benefit counseling functions.
- Be accountable for multiple electronic work queues in performing their duties.
- Work with internal and external customers, including patients, families, third party payers, clinical staff, and review organizations to accomplish their objectives.
High school diploma or GED preferred.
- At least 2 years experience in the healthcare or related field with emphasis on insurance prior authorization and referral processes preferred.
- Must be detail oriented and accurate.
- Excellent customer service, interpersonal and organization skills.
- Ability to use good judgments in highly emotional and demanding situations.
- Ability to react to frequent changes in duties and volume of work.
- Excellent oral and written communication skills.
- Ability to listen empathetically.
- Ability to logically and accurately organize details.
- Ability to manage multiple tasks with ease and efficiency.
- Self-starter with a willingness to try new ideas.
- Ability to work independently with minimal supervision and be result oriented.
- Positive, can-do attitude coupled with a sense of urgency.
- Effective interpersonal skills, including the ability to promote teamwork.
- Strong problem solving skills.
- Ability to ensure a high level of customer satisfaction including employees, patients, visitors, referring physicians and external stakeholders.
- Excellent computer operating skills (keyboard, mouse).
- Ability to use various computer applications including EPIC and MS Office.
- Basic math skills and knowledge of general accounting principles.
- Maintains confidentiality of sensitive information.
- Broad knowledge of health care business office practices and principles.
- Knowledge of medical and insurance terminology, CPT, ICD coding structures.
- Knowledge of Business Office policies and procedures.
- Ability to type 35 words per minute preferred.
SwedishAmerican offers a competitive compensation and benefits package. Work experience that is relevant to the position will be taken into consideration when determining the starting base pay.
SwedishAmerican serving northern Illinois and southern Wisconsin communities--also a Magnet®-designated facility-- is dedicated to delivering high quality healthcare and strategies to keep our patients and their families well. In fact, quality drives all that we do. In recent years, our commitment to quality and excellence has resulted in more national awards, for quality and preference than any other health system in northern Illinois.
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SwedishAmerican, A division of UW Health values and embraces diversity and is proud to be an Equal Employment Opportunity, Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, gender identity or expression, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.