[Hiring] Authorization and Cost Estimate Analyst Lead @The Christ Hospital Health Network

Role Description

The Insurance Authorization & Cost Estimate Specialist Lead is responsible for facilitating the concerted efforts of the Team to achieve and sustain desirable levels of customer service, accuracy of patient information for authorizations, estimates, and patient assistance efficiently.

• Works in an integrated, harmonious manner with other team leads, departments, and managers.
• Serves as a mentor and role model for fellow team members through demonstrating an outstanding work ethic, superior technical knowledge, and concern for the values and mission.
• Maintains access to resources and ensures that accounts are complete and secure.
• Leads the team to collect necessary insurance benefit and clinical information to properly authorize the ordered service with the patient’s insurance company.
• Supports insurance and benefit verification, pre-certification, and pre-authorization processes.
• Must have clinical knowledge of services to communicate appropriate information to the insurance company.
• Ensures reimbursement for the service rendered is dependent upon the insurance benefit verification process and meeting the authorization requirements of the insurance company.
• Determines when the patient is under-insured so that additional funding sources can be evaluated and applied.
• Determines the cost for the service by applying patient benefits/coverage information and estimate functionality accessible through IT applications.
• Ensures the patient understands their financial responsibilities for the service rendered.
• Operates in a dynamic environment as insurance plans, benefits, and coverage structures change frequently.
• Requires expert knowledge of insurance plans, insurance regulations, and insurance benefits and coverages as they relate to the service rendered.
• Serves as a point of contact within the organization for questions and issues related to insurance plans and coverage information.

Qualifications

• Expert knowledge of insurance plans and regulations.
• Clinical knowledge of services.
• Strong work ethic and technical knowledge.

Requirements

• Ability to work in a dynamic environment.
• Strong communication skills for interacting with patients and insurance companies.
• Experience in insurance benefit verification and authorization processes.

Benefits

• Competitive salary.
• Health and wellness programs.
• Opportunities for professional development.