Access Coordinator, Internal Medicine- Immunology, Full Time, First Shift

UC Health (Cincinnati); Lake Township (OH); On-site; USD 38,000 - 58,000; Full time

Job summary

UC Health is seeking an Insurance Verification professional to obtain pre-certifications and verify patient benefits. You will ensure coverage for outpatient services, document data in the Epic system, and manage daily worklists while communicating with management about issues and improvements.

The role requires a high school diploma and 1–2 years of experience in verification or prior authorizations in healthcare settings; 3–5 years is preferred.

Qualifications

• High School Diploma or GED.
• 1-2 years of experience completing pre-certifications/prior authorizations in a hospital, medical office, Patient Access or similar environment.
• Preferred: 3-5 years of related hospital or medical office experience.

Responsibilities

• Initiates online verification and/or makes phone contact with Insurance Carriers to verify patient benefits.
• Ensures precertification/authorization is obtained for high-dollar outpatient procedures.
• Documents complete eligibility, benefits and precert information in Epic databases.
• Effectively organizes prioritization of Daily Worklist tasks.
• Reports improvements, problems and changes to department management.
• Performs other duties as assigned.

Education

High School Diploma or GED

Job description

At UC Health, we're proud to have the best and brightest teams and clinicians collaborating toward our common purpose: to advance healing and reduce suffering.

As the region's adult academic health system, we strive for innovation and provide world-class care for not only our community, but patients from all over the world. Join our team and you'll be able to develop your skills, grow your career, build relationships with your peers and patients, and help us be a source of hope for our friends and neighbors.

UC Health is committed to providing an inclusive, equitable and diverse place of employment.

Verification of insurance coverage utilization different on-line modalities for clinic patients receiving diagnostic testing (i.e. CT, MRI, etc.),along with chemotherapy and radiation therapy and/or surgical procedures. The associate is responsible for obtaining prior authorization requests and/or pre-determination for these services to ensure maximum reimbursement to the organization.

Insurance Verification:

• Initiates on-line verification and/or makes phone contact with Insurance Carriers and Plan Administrators to verify patient benefits to precert all outpatient services are secure.
• Ensures authorization has been obtained for all scheduled and non-scheduled high dollar outpatient procedures.
• Follows up on missing data or problem accounts.

Documentation:

Documents complete and accurate data relating to all necessary eligibility, benefits and precertification information in appropriate Epic database fields. Informs management of trends of incomplete data, registration issues, etc.

Worklists:

Effectively organizes prioritization of Daily Worklist task.

Secure Accounts:

Secures all applicable accounts in timely manner as defined by Due Diligence Standard while maintaining department productivity and quality standards.

Communication:

Reports improvements, problems and changes as it relates to insurance verification to department management.

Other duties as assigned:

Performs other duties as assigned.

Minimum Required:

• High School Diploma or GED.
• 1 - 2 Years equivalent experience completing Pre-certifications/prior authorizations in a hospital setting, medical office setting, Patient Access or similar environment.

Preferred:

• 3 - 5 Years equivalent experience completing Pre-certifications/prior authorizations in a hospital setting, medical office setting, Patient Access or similar environment.