Authorization Representative Details

Authorization Representative

UW Health - Middleton, WI

Employment Type : Full-Time

Join the #1 hospital in Wisconsin!

We are seeking an Authorization Representative to:

• Obtain prior authorization from payers for inpatient and outpatient services provided by UW Health.
• Demonstrate skilled communication and troubleshooting techniques as well as excellent customer service skills.
• Anticipate and respond to a wide variety of issues/concerns and the ability to execute tasks efficiently and effectively.

Education :

Minimum – High school diploma or equivalent
Preferred - Associate’s Degree in Business, Finance, Health Information Management, or a related field.

Work Experience :
Minimum – One (1) year of experience in healthcare, business, finance, or insurance related field.
Preferred – One (1) year of experience in Healthcare Revenue Cycle that includes prior authorization. Knowledge of CPT and ICD coding highly desired. Knowledge of Medicare and third-party payer regulations and guidelines highly desired.

Required Skills, Knowledge, and Abilities :

• Maintains current knowledge of medical modalities as well as new protocols established for patient populations.
• Solid understanding and knowledge of payer contractual requirements, registration workflows, and prior authorization requirements to ensure staff follow established procedures to maximize reimbursement and minimize write offs.
• Excellent written and oral communication skills.
• Maintains effective and cooperative working relationships with co-workers, leaders, clinical staff and the public.
• Must be detail oriented and accurate.
• Displays a professional appearance.
• Dependable and reliable in achieving goals.
• Experience operating office machines such as personal computers, fax machines, photocopier, and document scanners.
• Familiarity with medical terminology and abbreviations.

Physical Requirements :

Sedentary: Ability to lift up to 10 pounds maximum and occasionally lifting and/or carrying such articles as dockets, ledgers and small tools. Although a sedentary job is defined as one, which involves sitting, a certain amount of walking and standing is often necessary in carrying out job duties. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Our Commitment to Diversity, Equity, and Inclusion

UW Health is committed to being a diverse, equitable, inclusive and anti-racist workplace and is an Equal Employment Opportunity, Affirmative Action employer. Our integrity shines through in patient care interactions and our daily work practices as we work to embrace the knowledge, unique perspectives and qualities each employee and faculty member brings to work each day. Applications from Black, Indigenous and People of Color (BIPOC) individuals, women, and LGBTQ+ and non-binary identities are strongly encouraged. EOE, including disability/veterans

W ork Schedule :
Part-time 60% FTE. Scheduled shifts are 8:30 AM - 5:00 PM, three days per week. Hours may vary depending on the needs of the department.

UW Health Administrative Facilities - UW Health has administrative locations throughout Madison and beyond where thousands of employees provide vital support to our clinical areas. These locations are home to departments such as Access Services, Compliance, Human Resources, Information Services, Patient Medical Records, Payroll and many others.