Verification of insurance coverage utilization different on-line modalities for clinic patients receiving diagnostic testing (i.e. CT, MRI, etc.),along with chemotherapy and radiation therapy and/or surgical procedures. The associate is responsible for obtaining prior authorization requests and/or pre-determination for these services to ensure maximum reimbursement to the organization.

Responsibilities

Insurance Verification

Initiates on-line verification and/or makes phone contact with Insurance Carriers and Plan Administrators to verify patient benefits to precert all outpatient services are secure.. Ensures authorization has been obtained for all scheduled and non-scheduled high dollar outpatient procedures. Follows up on missing data or problem accounts.

Documentation

Documents complete and accurate data relating to all necessary eligibility, benefits and precertification information in appropriate Epic database fields. Informs management of trends of incomplete data, registration issues, etc.

Worklists

Effectively organizes prioritization of Daily Worklist task.

Secure Accounts

Secures all applicable accounts in timely manner as defined by Due Diligence Standard while maintaining department productivity and quality standards.

Communication

Reports improvements, problems and changes as it relates to insurance verification to department management.

Other duties as assigned:

Performs other duties as assigned.

Qualifications

Minimum Required: High School Diploma or GED. | Minimum Required: 1 - 2 Years equivalent experience completing Pre-certifications/prior authorizations in a hospital setting, medical office setting, Patient Access or similar environment. • Preferred: 3 - 5 Years equivalent experience completing Pre-certifications/prior authorizations in a hospital setting, medical office setting, Patient Access or similar environment.

At UC Health, we're proud to have the best and brightest teams and clinicians collaborating toward our common purpose: to advance healing and reduce suffering.

As the region's adult academic health system, we strive for innovation and provide world-class care for not only our community, but patients from all over the world. Join our team and you'll be able to develop your skills, grow your career, build relationships with your peers and patients, and help us be a source of hope for our friends and neighbors.

UC Health is an EEO employer.

High school diploma or GED; 1-2 years experience completing pre-certifications/prior authorizations in a hospital, medical office, or patient access setting; Epic database proficiency.

Key Responsibilities

• verifying insurance
• obtaining authorizations
• documenting data

Skills & Tools

Epic

Job Details

• Category: Healthcare Services - Allied Health
• Seniority: Entry Level
• Commitment: Full Time
• Workplace: Remote — Cincinnati, Ohio, United States
• Languages: English

About UC Health

An academic health system providing world-class care and advancing healing. — Industry: Healthcare