[Hiring] Insurance Specialist I @UT Southwestern Medical Center

Role Description

The Pre-Arrival Financial Services Department team at UT Southwestern Medical Center has a new opportunity for an Insurance Specialist I. Candidates hired for this role are responsible for:

• Completing insurance verifications
• Obtaining prior authorizations
• Coordinating referral requirements for scheduled Radiology Imaging services

The Insurance Specialist I will work closely with clinical departments, payers, and patients to:

• Resolve coverage issues
• Secure required authorizations
• Ensure financial clearance for appointments

Work From Home (WFH): This position is remote; however, applicants must be based in the Greater DFW area. Further details will be discussed during the interview.

Shift: 8-hour days, Monday through Friday. Additional details will be discussed during the interview.

Qualifications

• High School education
• 2 years of benefit verification/authorization experience or equivalent
• 1 year of customer service experience
• 2 years of clinical/medical/precertification/predetermination/authorizations/verification experience
• 4 years of experience with desktop tools (Microsoft Outlook, Microsoft Word)
• 4 years of experience with office equipment (fax, copier)

Requirements

• Monitors the correct patient work queue to determine accounts needing verification
• Coordinates with physician's office and/or ancillary department regarding additional information needed to obtain pre-certification and insurance benefits
• Maintains department productivity standards
• Pre-registers patient cases by entering complete and accurate information prior to patient's arrival
• Documents pertinent information and efforts in computer system based upon department documentation standards
• Verifies insurance information by utilizing insurance websites or calling insurance companies
• Creates and calls patients with cost estimates for scheduled appointments
• Ensures all exams are scheduled with proper patient class and clinical indicators
• Monitors, verifies, transcribes faxed documents to select insurance companies regarding authorization requests
• Accurately monitors, reviews, data enters and processes authorizations
• Signs into and answers the assigned ACD line, documenting patient accounts
• Follows strict quality measures of documents scanned into the electronic medical record
• Protects the privacy and security of patient health information
• Counsels offices and/or patients when an out of network situation arises
• Coordinates with case management, physician's office and/or ancillary department regarding additional information needed
• Pre-registers patient cases by entering complete and accurate information in EPIC ADT hospital billing system
• Confirms accuracy of scheduled procedures and validates authorization codes
• Contacts patients to collect critical information and/or to advise of benefits information
• Maintains strictest confidentiality in accordance to policies and HIPAA guidelines
• Enters accurately prior authorization data in accordance with established guidelines
• Performs other related duties and projects as assigned

Benefits

• PPO medical plan, available day one at no cost for full-time employee-only coverage
• 100% coverage for preventive healthcare - no copay
• Paid Time Off, available day one
• Retirement Programs through the Teacher Retirement System of Texas (TRS)
• Paid Parental Leave Benefit
• Wellness programs
• Tuition Reimbursement
• Public Service Loan Forgiveness (PSLF) Qualified Employer