Insurance Verification and Authorization Specialist, Full-Time, Days

University of Chicago Medicine•Crown Point, IN

1d•Hybrid

About The Position

Join a world-class academic healthcare system, UChicago Medicine Crown Point , located in Crown Point, Indiana as a Insurance Verification & Authorization Specialist . UChicago Medicine is an integrated academic and community health system with multiple primary medical facilities within the surrounding suburbs of Chicago. UChicago Medicine, Crown Point is a two-story, 130,000-square-foot multispecialty care center and micro-hospital in Northwest Indiana, the academic health system's largest off-site facility and its first freestanding building in Indiana. Under the general supervision of the Patient Access Manager, the Insurance Verification & Authorization Specialist will perform imperative duties and assume the responsibility for successful financial clearance of all scheduled patient services. Collaborates with Managed Care office to identify and interpret contracts governing patient care and provide timely response and resolution to patient inquiries. This includes securing the authorization, HMO referral and verifying benefits and will include bedded patients to ensure that the notification of admission is completed timely. This role with exhibit strong customer service skills, sophisticated communication and critical thinking skills in response to patient/care team inquiries and requests. Initiates problem solving to resolve patient inquiries by referring escalated concerns to appropriate sources for resolution when necessary. This role requires strong multitasking abilities and the capabilities to make timely decisions in a fast-paced setting

Requirements

Associates’ degree in business, healthcare or related field and/or at least 5-7 years of Revenue Cycle experience with working knowledge of insurance and benefits required
Knowledgeable in medical terminology is strongly preferred.
Knowledgeable in diagnostic and CPT coding and guidelines is strongly preferred
3 years of prior Epic experience required
Knowledgeable in Microsoft Office applications strongly preferred
High degree of initiative and problem solving ability
Must be able to prioritize and execute multiple tasks, with accuracy, in a high-pressure environment
Must be able to demonstrate and maintain a strong customer service orientation and a commitment to excellence in a changing environment
Excellent communication skills and the ability to interact with people in a variety of contexts.
Must respect patient confidentiality and interact with patients, families and other customers with courtesy, tact and discretion.
Must be strongly invested in a team oriented dynamic environment and possess ability work independently, and make decisions in the best interest of the patient and the Hospitals
Ability and willingness to cooperate with co-workers, supervisors and physicians to do whatever needs to be done in order to serve the patient.
Possess the flexibility to learn and incorporate new systems and processes as technology advances.

Nice To Haves

Certificate is a plus.

Responsibilities

Secure HMO referrals as necessary based on plan and service prior to the date of service
Contact the insurance company via phone or portal to review benefits, understand authorization requirements, initiate the authorization, supply clinicals as needed, and follow up on authorization decision.
Serve as the liaison between the providers, ancillary areas, utilization management, patient financial services, etc.
Contacts patients as necessary to obtain additional information as needed for accurate and timely billing.
Complete the notification of admission on bedded patients in accordance with the payer guidelines and department standards.
Work collaboratively with our vendor partners to ensure timely screening for Medicaid coverage.
Accurate documentation in the EMR to support the account activity for financial clearance.
Requires demonstrated proficiency in EPIC WQs management, including insurance benefit verification and precise account documentation in alignment with organizational requirements
Adheres to established standard work and utilizes communication tools to ensure consistent and exceptional patient care.
Initiates problem solving to resolve patient questions/complaints and refers escalated concerns to appropriate sources for resolution.
Responsible for handling inbound calls, aiming for one-call resolution, and meeting all call center performance metrics.
Communicates with other department team members to coordinate a good patient experience.
Cross-covers multiple EPIC WQs (i.e. Micro hospital, Radiology, Laboratory, Ambulatory Surgery Center, Cancer Center, Radiation Oncology, Infusion, Multispecialty clinc(s).
Demonstrates behavior consistent with the patient centered care philosophy.
Takes initiative in seeking feedback on performance and responses appropriately to constructive feedback given.
Adhere to UCM attendance policy and performance department expectations.
Performs other duties as assigned.
Completes additional responsibilities as directed by management.