Insurance Verification Representative - Remote (Tri-County Area)

University of Miami • Medley, FL

123d • Remote

About The Position

The University of Miami/UHealth Central Business Office has an exciting opportunity for a full-time Insurance Verification Representative to work remotely. This position involves ensuring timely completion of accounts to support patient satisfaction and facilitate referral and authorization activities prior to the patient's date of service. The representative will verify eligibility and benefits, manage insurance information, and assist in educating patients about the referral and authorization process.

Requirements

• High School Diploma or equivalent.
• Minimum 1 year of relevant work experience.
• Computer literate; EPIC scheduling and registration application experience is a plus.
• Strong written and oral communication skills.
• Ability to work in a team environment.
• Ability to remain graceful under pressure and stressful situations.
• Demonstrated knowledge of insurance, including authorization/referral guidelines and requirements.
• Ability to communicate effectively in written and verbal form; bilingual knowledge is a plus.
• Ability to interact and assist patients of all ages and cultural backgrounds.
• Ability to work under high stress with time constraints while maintaining composure.
• Maintain a high level of diplomacy when dealing with stressful situations.
• Innovative, proactive, and resourceful in problem-solving.

Nice To Haves

• Bi-lingual knowledge.

Responsibilities

• Complete accounts in a timely manner to support patient satisfaction and allow for referral and authorization activities prior to the patient's date of service.
• Verify eligibility and benefits via RTE in UChart, online insurance websites, telephone or other automated services.
• Add and/or edit insurance information in UChart, ensuring accurate subscriber information, policy number, and claims address.
• Complete the checklist and document co-pay.
• Create referrals if applicable, documenting benefits information such as deductible, co-insurance, and out-of-pocket benefits.
• Meet productivity standards for assigned work queue, maintaining a QA goal of 95% or greater.
• Assist in educating and act as a resource to patients and healthcare practices within the UHealth system.
• Contact Primary Care Physician offices and/or Health Plans to obtain authorization or referral for scheduled services.
• Obtain authorization for both facility and provider for specific clinic locations.
• Enter and attach authorization information in the referral section of UChart.
• Approve referrals and financially clear visits.
• Communicate with patients and/or departments regarding authorization denial and/or re-direction of patients.
• Contact departments and/or patients when additional information is required or to alert regarding pending authorization status.
• Participate in process improvement initiatives.
• Provide customer service and assist patients and other UHealth staff with insurance-related questions.
• Ensure patients are aware of issues regarding their financial clearance and educate them on the referral/authorization process.
• Collaborate with Department and Patient Access teams to ensure timely communication.
• Implement service recoveries and escalations with guidance from supervisors.
• Perform other duties as assigned.

Benefits

• Competitive salaries.
• Comprehensive benefits package including medical, dental, and tuition remission.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Educational Services
• Education Level: High school or GED