NWIN Insurance Verification and Authorization Specialist, Full Time - Days

University of Chicago•Crown Point, IN

4d•Hybrid

About The Position

UChicago Medicine-NWIN Crown Point is hiring an Insurance Verification and Authorization Specialist under the general supervision of the Patient Access Manager. The specialist is responsible for the successful financial clearance of scheduled patient services, including securing authorizations and HMO referrals, verifying benefits, and completing timely admission notifications for bedded patients. The role collaborates with the Managed Care office to interpret contracts governing patient care and respond to patient inquiries. It requires strong customer service, communication, critical-thinking, and problem-solving skills when addressing questions and requests from patients and care teams, with escalation of concerns to appropriate sources when necessary.

Requirements

Associate degree in business, healthcare, or a related field, and/or at least 3 years of revenue cycle experience with working knowledge of insurance and benefits.
At least 3 years of prior Epic experience.
Ability to prioritize and accurately execute multiple tasks in a high-pressure environment.
Strong customer-service orientation and commitment to excellence in a changing environment.
Excellent communication skills and ability to interact with people in varied contexts.
Respect for patient confidentiality and courtesy, tact, and discretion when interacting with patients, families, and other customers.
Ability to work in a team-oriented environment and independently, making decisions in the best interests of patients and the hospitals.
Ability and willingness to cooperate with coworkers, supervisors, and physicians to serve patients.
Flexibility to learn and incorporate new systems and processes as technology advances.
High initiative and problem-solving ability.

Nice To Haves

Knowledge of medical terminology; a related certificate is a plus.
Knowledge of diagnostic and CPT coding and guidelines.
Knowledge of Microsoft Office applications.

Responsibilities

Secure HMO referrals, as required by the plan and service, before the date of service.
Contact insurance companies by phone or portal to review benefits, determine authorization requirements, initiate authorizations, provide clinical information as needed, and follow up on decisions.
Serve as a liaison among providers, ancillary areas, utilization management, patient financial services, and other parties.
Collaborate with partners to ensure timely screening for Medicaid coverage.
Document account activity accurately in the EMR to support financial clearance.
Assist with assigned Epic work queues and correct account deficiencies promptly for billing.
Contact patients to obtain additional information needed for accurate and timely billing.
Complete admission notifications for bedded patients according to payer guidelines and department standards.
Respond to patient and care-team inquiries, resolve problems, and refer escalated concerns to appropriate sources when needed.
Collaborate with the Managed Care office to identify and interpret contracts governing patient care.