Remote - Insurance Authorization Verification
4 weeks ago
**What we do here changes the world.** UTHealth Houston is Texas’ resource for healthcare education, innovation, scientific discovery, and excellence in patient care. That’s where you come in.
**This position is fully REMOTE**
**Must be located in Texas.**
**Once you join us you won't want to leave.** It’s because we reward our team for the excellent service they provide. Our total rewards package includes the benefits you’d expect from a top healthcare organization (benefits, insurance, etc.), plus:
- 100% paid medical premiums for our full-time employees
- Generous time off (holidays, preventative leave day, both vacation and sick time - all of which equates to around 37-38 days per year)
- The longer you stay, the more vacation you’ll accrue
- Longevity Pay (Monthly payments after two years of service)
- Build your future with our awesome retirement/pension plan
**We take care of our employees** As a world-renowned institution, our employees’ wellbeing is important to us. We offer work/life services such as...
- Free financial and legal counseling
- Free mental health counseling services
- Gym membership discounts and access to wellness programs
- Other employee discounts including entertainment, car rentals, cell phones, etc.
- Resources for child and elder care
- Plus many more
**Position Summary**:
Works to achieve team and departmental goals by serving as a team lead for the Insurance Verification team responsible for verifying insurance policy benefit information and obtaining Authorization / Precertification, prior to the patient’s visit or scheduled admission, or immediately following admission. Identifies problems and ensures that the insurance is accurate on the patient account. Assures insurance information and appropriate referrals have been completely and accurately obtained.
**Position Key Accountabilities**:
- Verifies insurance policy benefits for new and returning patients with carriers and employers.
- Assures all insurance information has been completely and accurately obtained. Documents all pertinent insurance information. Documents information given or received to support actions taken on insurance charges or referral issues.
- Identifies complex special policy clauses or pre-existing conditions and verifies effective date of policies.
- Mentors and serves as a resource for less experienced staff.
- Educates patients and families on insurance issues. Communicates patient’s fiscal responsibility in a professional manner.
- Ensures that accurate notification of patient’s insurance coverage, authorizations, or status is provided to all involved work units and departments.
- Identifies all patients without third party financial benefits and directs them for financial counseling according to Financial Counseling and Revenue Cycle policies and procedures.
- Receives and reviews UT-H Health Science Center’ Managed Care contracts to understand the contract provisions. Interprets managed care contracts for insurance coverage.
- Provides support to Revenue Cycle work units and other work units as assigned.
- Performs other duties as assigned.
**Certification/Skills**:
Excellent communication skills, both oral and written.
Proven ability to effectively problem solve.
Must have skill in establishing and maintaining effective working relationships with other employees, patients, governmental and commercial payer representatives.
**Minimum Education**:
High school or equivalent required. Graduate from a vocational business school in job related field or an Associate’s Degree preferred.
**Minimum Experience**:
Five (5) years medical office experience required with good understanding of third party reimbursement procedures. Must have experience in working with various insurance companies including both governmental and commercial insurance plans.
**Physical Requirements**:
Exerts up to 20 pounds of force occasionally and/or up to 10 pounds frequently and/or a negligible amount constantly to move objects.
**Security Sensitive**:
**Residency Requirement**:
Employees must permanently reside and work in the State of Texas.
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