Patient Authorization Representative

UMC Health System

2d•Onsite

About The Position

The Patient Authorization Representative is responsible for verifying insurance eligibility and ensuring all authorizations for pre-certifications, inpatient and out-patient exams/tests are received. This role involves coordinating with various departments, insurance companies, and sometimes patient families to ensure continuity of care, financial responsibility, and maximum reimbursement for services provided. The Cancer Center Patient Authorization Representatives also work with the Financial Aid Office for screening determination of a patient's ability to pay.

Requirements

High School Diploma or GED
+2 years of experience working with insurance verifications and pre-certifications, preferably in a hospital setting
+2 years use of medical terminology and billing codes
Excellent customer service skills; Must speak, read, and write English fluently
Ability to multi-task, handle problems, interruptions, and other stressful situations in a professional manner.
Demonstrate planning, organizational and ability to follow-through until a process is complete.

Responsibilities

Verify insurance eligibility and benefits.
Obtain and update patient benefits, identifying limitations and/or exclusions for each particular plan as it pertains to the patient’s care.
Coordinate physician and/or facility referrals and pre-certifications for patient appointments.
Communicate with other hospital departments, insurance companies, and at times, patient’s family members to ensure continuity of care for reoccurring appointments, financial responsibility, and to ensure facility receives maximum reimbursement for services provided.
Collect payments, establish payment arrangements, discuss payment options.
Perform all other related assigned duties.