Remote Order Processing Jobs in Racine, WI (NOW HIRING)

Remote position. Monday-Friday 8:30am-5pm CST.

Pay Range:

Major Responsibilities:

• Complete insurance verification and eligibility checks.
• Collect and accurately document initialpre-certification/authorizationinformation if available. Initiates the process of obtaining a requiredreferral/authorizationif not obtained.
• Work assigned Epic work queue, following the department's workflow process on appropriately transferring, deferring, or removing orders from the work queue.
• Proactively communicate issues involving customer service and process improvement opportunities to management.
• Maintains excellent public relations with patients, patients' families and clinical staff as well as demonstrates a willingness and ability to work collaboratively with others for concise and timely flow of information.
• Maintains knowledge of and reference materials for Medicare, Medicaid and third-party payerrequirementsguidelines and policies, insurance plansrequiringpre-authorization/referraland a list of current accepted insurance plans.
• Update the patient, physician's office, and any necessary parties, through multiple methods asappropriate (including telephone, in-basket messaging, and electronic medical record),regardingresponses and outcomes of the prior authorizations.
• Act as a liaison betweenphysician's office, patient, and pharmacy benefit manager toinitiateand resolve appeals, as needed.
• Mayidentifyandassistpatients with access to internal and external financialassistanceprograms.
• May communicate to the patient and/orphysician'soffice when authorization is not obtained, or services are not covered, andexplainsthe potentialfinancial responsibility. Coordinates with patient, clinical team, andassistanceprograms to secure reimbursement or alternative covered options.
• Manages incoming and outgoing calls, which may include other Advocate team members, departments, patients, insuranceplansand/or copay foundation/assistanceprograms.

Licensure, Registration, and/or Certification Required:

• None Required

Education Required:

• HighSchool Graduate

Experience Required:

• Typically requires 1 year of experience in health care, insurance industry, pharmacy, or medical background

Knowledge, Skills & Abilities Required:

• Demonstrateabilitytoidentifyand understand issues and problems. Examines data and draws logical conclusions based on information available
• Ability to problem solve in a high profile and high stress area
• Mathematical aptitude,effectivecommunication, and critical thinking skills
• Ability to prioritize and organize workload
• Excellent Verbal and written communication skills
• Demonstrated technicalproficiencyincluding experience with insurance authorization/eligibility tools, EPIC, Microsoft Office, Internetbrowserand telephony systems

Physical Requirements and Working Conditions:

• Operates all equipment necessary to perform the job
• Exposed to normal office environment areas, or remote work area
• Must have the ability to lift to 10 lbs. occasionally
• Uses a computer continuously throughout the workday
• Must be able to sit for extended periods of time

Preferred Job Requirements

Preferred Education

• Noadditionaleducation is required

Preferred Experience

• Noadditionalexperience necessary

Preferred Knowledge/Skills/Abilities

• Knowledge of medical terminology

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

Our CommitmenttoYou:

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more - so you can live fully at and away from work, including:

Compensation

• Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training

• Premium pay such as shift, on call, and more based on a teammate's job

• Incentive pay for select positions

• Opportunity for annual increases based on performance

Benefits and more

• Paid Time Off programs

• Health and welfare benefits such as medical, dental, vision, life, andShort- and Long-Term Disability

• Flexible Spending Accounts for eligible health care and dependent care expenses

• Family benefits such as adoption assistance and paid parental leave

• Defined contribution retirement plans with employer match and other financial wellness programs

• Educational Assistance Program

Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview.