administrative assistant Jobs in Green Bay

administrative assistant

authorizations specialist

Caravel Autism Health

<div>The Authorization Specialist is responsible for preparing and submitting detailed prior authorization requests, following up on requests, and appeals to insurance companies, including relevant clinical information and supporting documentation for ABA services. This position ensures that authorization requests are handled in a timely, efficient, and accurate manner. The Authorization Specialist requires excellent organization and communication skills, and an in-depth knowledge of ABA insurance guidelines. This position will work closely with staff throughout the organization and outside entities, including insurance companies, patients, and third-party providers and organizations for both authorization and medical record requests from authorized individuals while ensuring proper release procedures are followed. This position is expected to be familiar with HIPAA and other state and federal regulations.
 Essential Functions:<ul><li>
Manages ABA prior authorizations process start to finish. This includes communicating with the clinical team, insurance companies and billing team while following set authorization processes, including necessary appeals.</li><li>
Maximizes revenue through thorough understanding and use of principles of ICD-10 and CPT Codes for treatment plans and ABA Therapy for authorizations.</li><li>
Verifies benefits with insurance companies.</li><li>
Maintains information/regulations of insurance utilization management policy and procedures and communicates changes to these policies and procedures with Manager.</li><li>
Acts as a resource for Caravel for authorizations and insurance verification issues, providing guidance and information to support the benefits authorization and reimbursement process.</li><li>
Provides information to client families about the authorization process, including Caravel&rsquo;s process for seeking authorization and updates on individual authorization status.</li><li>
Reviews denials and submits timely appeals as needed.</li><li>
Maintains client medical record and accurate billing information in the practice management systems.</li><li>
Perform monthly eligibility and enrollment verification for all clients. This includes communicating with families, the clinical team, the billing team, and the insurance company to process necessary funding changes in a timely matter.</li><li>
Review, prepares and submits patient medical records upon appropriate written request from authorized parties, in alignment with all applicable guidelines and regulations.</li><li>
Maintains strict confidentiality; adheres to all HIPAA guidelines/regulations.</li><li>
Excellent oral, written, and interpersonal communications skills.</li></ul>
Qualifications:<ul><li>
 High school diploma or equivalent,</li><li>
Prefer coursework and/or experience in medical health insurance and medical records management.</li><li>
 At least two years of previous medical insurance, billing, or claims processing related experience.</li><li>
Experience addressing billing and claims processing or insurance authorization related to developmental disabilities, including Autism Spectrum Disorder, preferred.</li></ul>
Skills and Competencies:<ul><li>
Strong keyboarding and computer skills including MS Office (Word and Excel) experience at an intermediate level.</li><li>
Knowledge of medical billing and ICD-10, and CPT coding, as well as knowledge of financial concepts related to authorizations, medical insurance, billing, and claims processing.</li><li>
Ability to abide by ethical guidelines and policies, including strict adherence to confidentiality and HIPPA guidelines.</li><li>
Excellent interpersonal skills, with the ability to communicate effectively with others.</li><li>
Strong organizational skills, with the ability to multi-task and meet deadlines.</li><li>
Demonstrates initiative, with the ability to manage self and workload.</li><li>
Strong analytical and problem-solving abilities.</li><li>
Exemplary customer service focus, for both internal and external clients.</li><li>
Strong team player.</li><li>
Displays professionalism and represents organization in a professional manner.</li></ul></div>

Authorizations Specialist

Optum

<div>Explore opportunities with CPS, part of the Optum family of businesses. We're dedicated to crafting and delivering innovative hospital and pharmacy solutions for better patient outcomes across the entire continuum of care. With CPS, you'll work alongside our team of more than 2,500 pharmacy professionals, technology experts, and industry leaders to drive superior financial, clinical, and operational performance for health systems nationwide. Ready to help shape the future of pharmacy and hospital solutions? Join us and discover the meaning behind Caring. Connecting. Growing together. 
As a Specialty Pharmacy Liaison with CPS Solutions, LLC, you will engage directly with patients to coordinate pharmacy services through the health system's specialty and retail pharmacy. Acting as a bridge between patients, providers, and the pharmacy, this role focuses on improving prescription capture, providing follow-up counseling, and ensuring smooth communication. Key duties include processing prior authorizations, assisting with financial aid, updating clinical data, and supporting administrative tasks. 
Pharmacy Location: Located within Hospital Sisters Health System (HSHS) in Green Bay, WI
Schedule: Monday through Friday, either 8AM-4:30PM or 8:30AM-5:00PM 
Primary Responsibilities:<ul><li>
Explain the benefits of specialty pharmacy services to patients and support their participation in the program</li><li>
Assist with enrolling patients into the specialty pharmacy program</li><li>
Complete benefits investigations, prior authorizations, and financial assistance tasks to help ensure patients can access prescribed medications</li><li>
Coordinate with pharmacy team members to support accurate and timely processing of patient orders</li><li>
Provide direct patient support through outbound adherence and refill reminder calls and assist with inbound patient inquiries</li><li>
Route clinical questions to the appropriate clinician as needed</li></ul> 
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:<ul><li>
High school diploma or equivalent</li><li>
Active Pharmacy Technician license in good standing in the state of Wisconsin</li><li>
Recent work experience as a Pharmacy Technician</li></ul> 
Preferred Qualifications:<ul><li>
PTCB</li><li>
Experience supporting clinical pharmacy programs and performing administrative tasks such as prior authorizations and data entry</li><li>
Solid knowledge of medication regimens, age-specific dosing, and managed care practices</li><li>
Proficient in pharmacy systems, care management platforms, and Microsoft Office (Outlook, Word, Excel)</li></ul> 
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $17.98 to $32.12per hour based on full-time employment. We comply with all minimum wage laws as applicable. 
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. 
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. 
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.</div>

Specialty Pharmacy Liaison

Explore 2+ Authorizations specialist in Green Bay this March. Find roles across top companies and apply now to boost your career.

2 authorizations specialist jobs In Green Bay

Authorizations Specialist

Specialty Pharmacy Liaison