Referral & Auth. Specialist (Remote); 1.0 FTE; Day Shift

UnityPoint Health - Meriter Hospital•Madison, OH

3d•Remote

About The Position

Referral and Authorization Specialists support Meriter’s Financial Clearance process to help secure optimal reimbursement for services. They verify that patient and insurance information is obtained and documented in Epic, including through coverage and eligibility verification, benefit collection, and authorization procurement. They document detailed information to ensure authorizations are in place for scheduled services and direct admissions. The role works directly with referring providers to obtain shared authorizations and collaborates with members of various hospital departments. It requires a thorough understanding of insurance plans and patient benefits. This is a remote position, with on-site training for up to four weeks; candidates should be in the Madison, Wisconsin region. The schedule is weekdays, 8:30 a.m. to 5 p.m.

Requirements

High school diploma or equivalent.
One year of experience in a healthcare setting performing scheduling, registration, insurance verification, prior authorizations, and/or billing functions.
Experience with and working knowledge of medical terminology.
Prior customer service experience.
Knowledge of the healthcare insurance industry and regulations.
Knowledge of insurance verification using various websites or obtaining information by phone.
Strong written and verbal communication skills.
Standard keyboarding skills.
Knowledge of healthcare operations.
Team-oriented.

Nice To Haves

Prior Epic experience and knowledge of insurance terminology, benefits, and processes.
Previous experience working with or in the Epic system.
Working knowledge of Epic; preferred modules include ADT, Resolute, Cadence Referrals, and Radiant.
Working knowledge of medical terminology.
Working knowledge of insurance terminology, including CPT and ICD-10 codes.
Knowledge of Microsoft Office programs such as Word, Outlook, and Excel.

Responsibilities

Verify and document patient and insurance information in Epic.
Perform activities such as coverage verification, eligibility verification, benefit collection, and authorization procurement.
Document detailed information to ensure approved authorizations are in place for scheduled services and direct admissions.
Work with referring providers to obtain shared authorizations.
Build and maintain working relationships with members of various hospital departments.