UnityPoint Health
Preauthorization Specialist - Cardiology Center
UnityPoint Health - Allen | Shift: Monday - Friday, Daytime | 0.8 FTE (32 hours/week) | Full-time Benefits
Area of Interest: Patient Services
FTE/Hours per pay period: 0.8
Department: Cardiology- Donald Street
Job ID: 173946
Overview Obtains insurance eligibility, benefits, authorizations, and pre-certifications for scheduled and non-scheduled visits and procedures performed at hospital. Updates demographic and insurance information in system as needed. Primary documentation source for access and billing staff. Resolves accounts on work queues. Interacts in a customer‑focused and compassionate manner to ensure patients and their representatives’ needs are met. Assists in scheduling any non‑invasive procedures and/or tests as directed.
Why UnityPoint Health? At UnityPoint Health, you matter. We’re proud to be recognized as a Top 150 Place to Work in Healthcare by Becker’s Healthcare for several years in a row for our commitment to our team members. Our competitive Total Rewards program offers benefits options that align with your needs and priorities, no matter what life stage you’re in. We champion a culture of belonging where everyone feels valued and respected, and we support development opportunities to deliver an exceptional employment experience.
Benefits
Expect paid time off, parental leave, 401K matching and an employee recognition program.
Dental and health insurance, paid holidays, short and long‑term disability and more. We even offer pet insurance for your four‑legged family members.
Early access to earned wages with Daily Pay, tuition reimbursement to help further your career, and adoption assistance to help you grow your family.
Responsibilities
Work with providers to assure that CPT and ICD‑10 code is correct for procedure ordered and is authorized when necessary.
Complete eligibility check and obtain benefits through electronic means or via phone contact with insurance carriers or other agencies; provide initial clinical documentation when necessary/requested.
Initiate pre‑certification process with physicians, PHO sites or insurance companies and obtain pre‑cert/authorization numbers, adding them to the electronic health record and other pertinent information that secures reimbursement of account.
Perform follow‑up calls as needed until verification/pre‑certification process is complete.
Thoroughly document information and actions in all appropriate computer systems.
Notify and inform Utilization Review staff of authorization information to ensure timely concurrent review.
Validate or update insurance codes and priority for billing accuracy.
Work with insurance companies to obtain retroactive authorization when not obtained at time of service.
Qualifications Minimum Qualifications
High School or Vocational School graduate.
Strong customer service skills.
Proficient in entering information into a variety of computer programs.
Ability to understand and apply guidelines, policies and procedures.
Effective interaction with physicians, healthcare team members, individuals and members of their support systems.
Effective communication with people of diverse professional, educational and lifestyle backgrounds.
Fluent reading, writing, comprehension and speaking in English.
Multicultural sensitivity.
Basic Microsoft Office computer skills.
Customer/patient focused.
Critical thinking skills using independent judgement in making decisions.
Preferred
Previous medical office experience.
Experience with an electronic health record or medical office software.
Experience coding diagnoses and procedures with ICD‑9-CM and CPT.
Knowledge of medical terminology, anatomy and physiology.
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Area of Interest: Patient Services
FTE/Hours per pay period: 0.8
Department: Cardiology- Donald Street
Job ID: 173946
Overview Obtains insurance eligibility, benefits, authorizations, and pre-certifications for scheduled and non-scheduled visits and procedures performed at hospital. Updates demographic and insurance information in system as needed. Primary documentation source for access and billing staff. Resolves accounts on work queues. Interacts in a customer‑focused and compassionate manner to ensure patients and their representatives’ needs are met. Assists in scheduling any non‑invasive procedures and/or tests as directed.
Why UnityPoint Health? At UnityPoint Health, you matter. We’re proud to be recognized as a Top 150 Place to Work in Healthcare by Becker’s Healthcare for several years in a row for our commitment to our team members. Our competitive Total Rewards program offers benefits options that align with your needs and priorities, no matter what life stage you’re in. We champion a culture of belonging where everyone feels valued and respected, and we support development opportunities to deliver an exceptional employment experience.
Benefits
Expect paid time off, parental leave, 401K matching and an employee recognition program.
Dental and health insurance, paid holidays, short and long‑term disability and more. We even offer pet insurance for your four‑legged family members.
Early access to earned wages with Daily Pay, tuition reimbursement to help further your career, and adoption assistance to help you grow your family.
Responsibilities
Work with providers to assure that CPT and ICD‑10 code is correct for procedure ordered and is authorized when necessary.
Complete eligibility check and obtain benefits through electronic means or via phone contact with insurance carriers or other agencies; provide initial clinical documentation when necessary/requested.
Initiate pre‑certification process with physicians, PHO sites or insurance companies and obtain pre‑cert/authorization numbers, adding them to the electronic health record and other pertinent information that secures reimbursement of account.
Perform follow‑up calls as needed until verification/pre‑certification process is complete.
Thoroughly document information and actions in all appropriate computer systems.
Notify and inform Utilization Review staff of authorization information to ensure timely concurrent review.
Validate or update insurance codes and priority for billing accuracy.
Work with insurance companies to obtain retroactive authorization when not obtained at time of service.
Qualifications Minimum Qualifications
High School or Vocational School graduate.
Strong customer service skills.
Proficient in entering information into a variety of computer programs.
Ability to understand and apply guidelines, policies and procedures.
Effective interaction with physicians, healthcare team members, individuals and members of their support systems.
Effective communication with people of diverse professional, educational and lifestyle backgrounds.
Fluent reading, writing, comprehension and speaking in English.
Multicultural sensitivity.
Basic Microsoft Office computer skills.
Customer/patient focused.
Critical thinking skills using independent judgement in making decisions.
Preferred
Previous medical office experience.
Experience with an electronic health record or medical office software.
Experience coding diagnoses and procedures with ICD‑9-CM and CPT.
Knowledge of medical terminology, anatomy and physiology.
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