Pre-Verification Specialist - Corporate Headquarters
About the role
BayCare Clinic's mission is to provide measurably superior specialty medical services to patients. The Pre-Verification Specialist position is based at the Corporate Headquarters in Green Bay, WI. The clinic is a successful, dynamic group of 20+ specialties, physician‑owned with joint ownership in Aurora BayCare Medical Center (a 167‑bed hospital), providing a built‑in referral base. Each specialty practice enjoys clinical autonomy and is financially sound. The typical schedule is Monday‑Friday, 8:00 a.m. to 5:00 p.m., with no holidays or weekend work. The team values a positive, collaborative culture, offers regular professional development opportunities, seeks feedback and ideas, and encourages participation in various projects, giving every member a voice and ownership over their work.
Responsibilities
- Using appropriate methods, obtains prior authorizations for diagnostic studies, procedures, surgeries, and testing as required by each particular insurance company including Worker’s Compensation.
- Verifies patient status through use of websites and phone calls to insurance carriers as necessary.
- Reviews specific coverage policies for individual insurance companies to ensure that requirements are met.
- Updates patient-specific insurance information as necessary in appropriate systems.
- Assists clinic staff and patients who have miscellaneous insurance information questions.
- Documents appropriate and accurate information in electronic record systems.
- Documents prior authorizations in electronic record.
- Respects and maintains confidentiality.
- Works in a safe, compliant and ethical manner at all times.
Requirements
- AAS in Health Care Business or combination of education and experience preferred.
- Typically requires two years' experience with patients and providers in a 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.
- Epic Experience is a plus.
- Experience with Insurance Authorizations is a plus.
Skills
- Organizational skills
- Interpersonal skills
- Communication skills
- Computer proficiency
- Medical terminology knowledge
- Insurance verification process
- Epic experience (preferred)
- Insurance authorizations experience (preferred)
Benefits
- Comprehensive benefits package including health, dental, disability and life insurance
- Flexible spending options
- 401k retirement plan with company match
- Generous paid time off (PTO)
- Paid holidays