Prior Authorization Clerk (FT)

Description With a range of services - from emergency care to diagnostic imaging, rehabilitation and surgery - we serve people of all ages in Edgerton, Milton, Janesville and the surrounding communities. Edgerton Hospital has been the center of the community's health care since 1920, and we continue to grow and evolve in response to changing medical needs. Our Mission Improving Health & Wellness for Longer, Healthier Lives Our Vision We will serve our communities with exceptional quality, innovative health services and wellness promotion. Our Values I CARE Integrity. Compassion. Accountability. Respect. Excellence. Our Prior Authorization Clerk reports to the Director of Revenue Cycle and performs the following duties to support Edgerton Hospital: Performs clerical skills as necessary, including (but not limited to): insurance verification, prior authorizations, coordinating requests for release of information, and review and/or audit of patient records for completion, maintenance of medical records, and patient registration. Assists in completion and submission of paperwork. Audits patient medical records for completion of QA identified information. Reports summary of audit to Director monthly. Identifies areas for staff improvement. Actively and willingly takes on additional projects within the department or hospital. Continues to update skills by utilizing educational opportunities. Completes required hospital house wide education. Other duties as may be necessary to fulfill the responsibilities of the position. Requirements1-2 years healthcare experience preferred. Mathematical ability required for financial responsibilities and compiling/reviewing statistical data. Excellent customer relation skills. Possesses good communication skills. Competent in use of computer system. Possesses organizational skills. Demonstrates initiative and the ability to work independently. Sets priorities in work assignments. Physical: Sitting for long periods of time. Eye-hand coordination, finger dexterity, odor, color and texture perception and discrimination, functional visual ability and depth perception, functional sound perception and discrimination, and functional verbal speech ability. Occasional bending, twisting, balancing, and reaching at/or above shoulder level, as well as occasional kneeling and climbing. Ability to wear gloves and other protective equipment, if needed. Mental: Reading (simple & complex), writing (simple & complex), basic math skills, clerical, analysis/comprehension, judgment/decision making, computer skills.Working irregular hours. The ability to deal with pressure to meet deadlines, to be accurate, to handle constantly changing situations and to create a positive work environment. The ability to deal with a variety of people, deal with stressful situations, and handle conflict. The ability to communicate verbally and in writing in a professional manner, to gain new skills and knowledge necessary for the performance of essential job functions, and to give, receive, and analyze information.

Created: 2026-03-04