Insurance Specialist

University of Colorado•Aurora, CO

1d•Onsite

About The Position

The University of Colorado Anschutz Medical Campus has an opening for a full-time University Staff (unclassified) Insurance Specialist in the Department of Psychiatry. Clinics are located in Aurora Colorado at the School of Medicine. Programs in the various clinics include traditional psychiatric and psychological outpatient treatment; support and therapy groups, trauma care for adolescents and adults; Student Resident Mental Health; gender responsive services as well as specialty services for Women going through Cancer Therapy and Menopause. This position will report to and serve under the supervision of the Supervisor and Business Services Manager at the Department of Psychiatry. This position is responsible for managing various patient registration, revenue cycle and administrative duties for any assigned clinics. While providing those duties, they should endeavor to provide excellent customer service, leaving a positive impression on patients, providers and staff. They will be expected to perform routine insurance reviews, prior authorization requests, obtain and verify patient demographics, train clinic PSRs in all aspects of registrations, provide routine insurance updates, train insurance staff, and act as the subject matter expert for their assigned area. Additionally, this individual will be responsible for troubleshooting patient billing issues in coordination with CU Medicine. They will primarily focus on their assigned area but will also be expected to provide coverage to other clinical areas, as needed.

Requirements

Bachelor's degree from an accredited institution
1+ year of professional experience (insurance verification, financial counseling, patient financial services, patient registration).
A combination of education and related technical/military/paraprofessional experience may be substituted for a bachelor’s degree on a year for year basis.
Applicants must meet minimum qualifications at the time of hire.
Ability to communicate effectively, both in writing and orally.
Ability to establish and maintain effective working relationships with employees at all levels throughout the institution.
Outstanding customer service skills.
Team coordination and management.
Interpersonal skills.
Knowledge and understanding of insurance authorizations, EMR, eligibility software, scheduling software, scanning, and vendor systems.
Ability to use independent judgment.
Ability to comply with established rules, policies and procedures and meet deadlines.
Ability to exercise discretion (e.g. patient confidentiality).
Knowledge of HIPAA regulations.
Comfortable working in high volume, fast paced office environment.
Proficient in Microsoft Office programs and ability to learn software programs.
Strong organizational and time management skills with attention to detail.
Applicants must be legally authorized to work in the United States without requiring sponsorship.
We are unable to provide work visa sponsorship or employment authorization for this position now or in the future.

Nice To Haves

Two (2) or more years of experience in insurance verification, financial counseling, patient financial services, patient registration.
Experience using Electronic Health Record and Patient Health Information management systems.
Billing and coding experience.
Experience with healthcare EMR (EPIC).

Responsibilities

Evaluate and communicate patient’s potential financial liability directly to the patient prior to medical services being rendered based on insurance verification data and medical cost estimates.
Obtain insurance authorization and pre-certification for behavioral health services, document covered and non-covered benefits, plan type, co-payments, co-insurance, out of pocket, and deductible amounts and determining contract and benefit eligibility. Contact insurance companies as needed.
Review, process, and audit the medical necessity for each patient behavioral health treatment and documentation insurance authorization including review of CPT/ICD diagnosis codes.
Work as a patient advocate and functions as a liaison between the patient and payer to answer reimbursement questions and avoid insurance delays.
Communicate with patient access and medical staff to inform them of any restrictions or special requirements in accordance with insurance plans.
Update coding/payer guidelines for clinical staff and adheres to CU Medicine guidelines with obtaining authorization.
Track pathways and performs various other business office functions on an as needed basis.
Identifies and refers problematic workflow trends to Supervisor for evaluation and solution.