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Company

University of Miami Miller School of Medicine · 6 hours ago

Insurance Verification Representative (H)-REMOTE

Miami, FL

Full-time

Remote

Entry Level

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Responsibilities

Accounts are completed in a timely manner in support of patient satisfaction and allow for referral and authorization activities prior to the patient's date of service

Verification of eligibility and benefits via RTE in UChart, online insurance websites, telephone or other source of automated services

Add and/or edit insurance information in UChart such as validating that the correct guarantor account and plan listed in patient's account with accurate subscriber information, policy number, and claims address and plan order.

Completes the checklist and document co-pay.

Creates referral if applicable, "Benefit only" or "Preauthorization", and documents benefits information: deductible, co-insurance and out of pocket benefits

Meets productivity standards for assigned work queue, QA goal of 95% or greater and maintains WQ current at 14 days out with minimum daily pending visits

Assists in educating and acts as a resource to patients, primary care and specialty care practices within the UHealth system and externally

Contacts Primary Care Physician offices and/or Health Plan to obtain authorization or referral for scheduled services according to authorization guideline listed in UHealth Contract Summary. Submits all necessary documentation required to process authorization request

Obtains authorization for both facility and provider for POS 22 and POS 19 clinics and provider only for POS 11 clinic locations

Enters and attaches authorization information in referral section of UChart

Approves referral and financially clear visits

Communicates with patients and/or departments regarding authorization denial and/or re-direction of patient by health plan or PCP office

Contacts the Departments and/or patient when additional information is required of them or to alert regarding pending authorization status

Participates in process improvement initiatives 15% Customer Service

Provides customer service and assist patients and other UHealth staff with insurance related questions according to departmental standards

Ensures that patients are aware of issues regarding their financial clearance and educated on the referral/authorization process

Collaborates with Department and Patient Access teams to ensure that timely and concise communication occurs.

Ensures service recoveries and escalations are implemented with the guidance of their supervisors and according to departmental standards and guidelines

Performs other duties as assigned

Qualification

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Insurance verificationAuthorization guidelinesEPIC applicationBilingual communication

Required

High School Diploma or equivalent

Computer literate (EPIC scheduling and registration application experience a plus)

Strong written and oral communication skills

Able to work in a team environment

Graceful under pressure and stressful situations

Demonstrated knowledge of insurances, including authorization/referrals guidelines and requirements

Demonstrated ability to communicate effectively in written and verbal form

Demonstrated ability to communicate effectively with physicians, customers, teammates and other staff

Ability to interact and assist patients of all ages, cultural background and with special needs, with a passion for providing excellent service and care

Ability to work under a high level of stress with time constraints while maintaining composure and sensitivity to each patient's specific needs

Maintain a high level of diplomacy when dealing with stressful situations

Is innovative, proactive and resourceful in problem solving

Preferred

Bi-lingual knowledge a plus

Benefits

Medical

Dental

Tuition remission

And more

Company

University of Miami Miller School of Medicine

The University of Miami Leonard M. Miller School of Medicine is the graduate medical school of the University of Miami. It is a sub-organization of University of Miami.

Founded in 1952