Texas Medical Center
Insurance Authorization Verification Specialist II
Texas Medical Center, Houston, Texas, United States, 77001
Job Title
UTHealth Houston is Texas' resource for healthcare education, innovation, scientific discovery, and excellence in patient care. This role verifies insurance policy benefit information and obtains authorization/precertification, prior to the patient's visit or scheduled admission, or immediately following admission. Assist in identifying problems and ensures that the insurance is accurate on the patient account. Assures insurance information and appropriate referrals have been completely and accurately obtained. This position handles daily operations for assigned providers, including verifying insurance benefits, obtaining authorizations, and ensuring accurate referrals. Specialists maintain productivity, meet UTHealth metrics, and resolve insurance issues while delivering excellent patient service. Position Summary
Verifies insurance policy benefits for new and returning patients with carriers and employers. Assures all insurance information has been completely and accurately obtained. Documents all pertinent insurance information. Documents information given or received to support actions taken on insurance charges or referral issues. Identifies special policy clauses or pre-existing conditions and verifies effective date of policies. Educates patients and families on insurance issues. Communicates patient's fiscal responsibility in a professional manner. Notifies appropriate work units of patient's insurance coverage, authorizations, or status. Identifies all patients without third party financial benefits and directs them for financial counseling according to Financial Counseling and Revenue Cycle policies and procedures. Receives and reviews UT-H Health Science Center' Managed Care contracts to understand the contract provisions. Interprets managed care contracts for insurance coverage. Provides support to Revenue Cycle work units and other work units as assigned. Other duties as assigned. Certification/Skills
High school diploma or equivalent required; some college preferred. Three years of related experience required. Exerts up to 20 pounds of force occasionally and/or up to 10 pounds frequently and/or a negligible amount constantly to move objects. This position is a security-sensitive position pursuant to Texas Education Code 51.215 and Texas Government Code 411.094. Employees must permanently reside and work in the State of Texas.
UTHealth Houston is Texas' resource for healthcare education, innovation, scientific discovery, and excellence in patient care. This role verifies insurance policy benefit information and obtains authorization/precertification, prior to the patient's visit or scheduled admission, or immediately following admission. Assist in identifying problems and ensures that the insurance is accurate on the patient account. Assures insurance information and appropriate referrals have been completely and accurately obtained. This position handles daily operations for assigned providers, including verifying insurance benefits, obtaining authorizations, and ensuring accurate referrals. Specialists maintain productivity, meet UTHealth metrics, and resolve insurance issues while delivering excellent patient service. Position Summary
Verifies insurance policy benefits for new and returning patients with carriers and employers. Assures all insurance information has been completely and accurately obtained. Documents all pertinent insurance information. Documents information given or received to support actions taken on insurance charges or referral issues. Identifies special policy clauses or pre-existing conditions and verifies effective date of policies. Educates patients and families on insurance issues. Communicates patient's fiscal responsibility in a professional manner. Notifies appropriate work units of patient's insurance coverage, authorizations, or status. Identifies all patients without third party financial benefits and directs them for financial counseling according to Financial Counseling and Revenue Cycle policies and procedures. Receives and reviews UT-H Health Science Center' Managed Care contracts to understand the contract provisions. Interprets managed care contracts for insurance coverage. Provides support to Revenue Cycle work units and other work units as assigned. Other duties as assigned. Certification/Skills
High school diploma or equivalent required; some college preferred. Three years of related experience required. Exerts up to 20 pounds of force occasionally and/or up to 10 pounds frequently and/or a negligible amount constantly to move objects. This position is a security-sensitive position pursuant to Texas Education Code 51.215 and Texas Government Code 411.094. Employees must permanently reside and work in the State of Texas.