[Hiring] Insurance Specialist I @UT Southwestern Medical Center

Role Description

UT Southwestern Medical Center has a new opportunity available for an Insurance Specialist I.

• Work From Home (WFH): Applicants will work from home. Candidates must live within the Greater DFW area. Additional details to be discussed during the interview.
• Shift: 8-hour days, Monday thru Friday. Additional details to be discussed during the interview.

Qualifications

• High School education required.
• 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.
• Identifies and verifies all essential information pertaining to intake, insurance verification/eligibility, and precertification on all applicable patient accounts.
• 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 and coding nomenclature.
• Monitors, verifies, and 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 per documentation expectations.
• 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 becomes apparent.
• Verifies insurance coverage and eligibility for all applicable scheduled services.
• Coordinates with case management, physician's office, and/or ancillary department regarding additional information needed.
• Confirms accuracy of scheduled procedures and validates that authorization codes match the service delivered.
• Contacts patients to collect critical information and/or to advise of benefits information.
• Maintains strictest confidentiality in accordance with policies and HIPAA guidelines.
• Enters accurately prior authorization data in accordance with established guidelines.
• Performs other duties 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.