Access Coordinator, PBO Authorizations, Full Time, First Shift

UC Health; Oregon; Hybrid; USD 36,000 - 54,000; Full time

Job summary

UC Health in Oregon is seeking an Insurance Verification Clerk to support outpatient services by confirming coverage and precertifications. You will verify eligibility and assist with precertifications to maximize reimbursement. Strong data entry skills and accurate documentation in Epic are essential.

Work closely with clinical teams to ensure timely authorizations, maintain organized daily worklists, and communicate issues for continuous improvement in a dynamic hospital setting.

Qualifications

• Minimum required: High School Diploma or GED.
• 1–2 years in Pre-certifications or prior authorizations in hospital or medical office settings.

Responsibilities

• Verify insurance coverage for outpatient services such as CT/MRI and chemotherapy to ensure reimbursement.
• Obtain preauthorization or precertification for scheduled services.
• Document eligibility and benefits data in the Epic system.
• Maintain daily worklists and prioritize tasks.
• Secure accounts in a timely manner according to standards.
• Report issues and improvements to department management.

Skills

Insurance verification

Communication

Data entry

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.

Responsibilities

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 coverage eligibility and to precert all outpatient services ordered or performed by University of Cincinnati Physicians' Internal Medicine providers. Ensures authorization has been obtained for all scheduled and non-scheduled high dollar outpatient procedures to satisfy UC Health Financial Clearance and insurance reimbursement requirements. 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.

Qualifications

Minimum Required: High School Diploma or GED. | Minimum Required: 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.