Insurance Verification Rep I
About The Position
The Insurance Verification Rep I is responsible for efficiently handling work volume and queues to meet or exceed productivity standards. This role involves accurately collecting and verifying insurance information and demographics, obtaining insurance authorization, and entering the information into the required systems. The Insurance Verification Rep I also serves as a liaison between various hospital departments and collaborates with internal and external resources to confirm receipt of or obtain pre-authorization for scheduled services and medications. Additionally, the role involves making contact with families prior to scheduled visits to confirm insurance eligibility, referrals, and authorizations, and initiating calls to resolve issues, escalating problems as needed.
Requirements
- High school diploma or equivalent
- No directly related experience
Responsibilities
- Efficiently handle work volume and queues to meet or exceed productivity standards.
- Accurately collect and verify insurance information and demographics.
- Obtain insurance authorization and enter information into required systems.
- Serve as a liaison between Hospital/Physicians Billing Service, Admitting, Outpatient Surgery, Outpatient Department, Patient Financial Services, Utilization Review, and other Cincinnati Children's departments.
- Work insurance pre-authorization for multiple divisions.
- Utilize systems including medical records to obtain needed clinical support to confirm receipt of or obtain pre-authorization for scheduled services and medications.
- Collaborate with internal and external resources regarding specific authorization scenarios.
- Contact families prior to patient scheduled visits and/or services to confirm insurance eligibility, referrals/authorizations.
- Initiate calls to appropriate parties both internal and external to resolve issues.
- Escalate to appropriate staff regarding system errors, recurring divisional problems/errors identified within work queues or reports.
Benefits
- Additional pay (e.g., shift, on‑call, or weekend differentials) may apply.
- Benefits may apply.
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What This Job Offers
Job Type
Part-time
Career Level
Entry Level
Education Level
High school or GED
