Patient Access & Insurance Authorization Specialist

University of California; Los Angeles (CA); On-site; USD 44,000 - 63,000; Full time

Job summary

University of California in Los Angeles is seeking a Pre-Registration Representative to pre-register and pre-admit patients by phone or in person, review benefits, and coordinate with hospital departments to ensure accurate reimbursement.

The role includes collecting demographic information, implementing Medicare requirements, and interacting with physicians and staff to streamline admissions. Knowledge of ICD-10/CPT-4/HCPCS and payor verification is essential.

Qualifications

• Knowledge of ICD-10, CPT-4, and HCPCS codes as applied to authorization submission and claims reimbursement.
• Knowledge of authorization submission and reimbursement for high cost specialty services and medication administration.
• Knowledge of medical terminology to sufficiently identify various procedures to obtain optimum benefit information and reimbursement.
• Knowledge of third party payor verification terminology.
• Knowledge of State and Federal programs to ensure reimbursement from Medicare, Medi-Cal, CCS programs, out-of-state Medicaid, or other sponsoring agencies.
• Knowledge of healthcare insurance and medication prior authorization & basic working knowledge of coding.
• Strong oral and written communications skills.
• Typing proficiently including 10-key, focusing on accuracy and speed.

Responsibilities

• Pre-registers and pre-admits patients by telephone and/or in person.
• Review and interpretation of insurance benefits, cash collections, interaction with public assistance programs (i.e. Medi-Cal, CCS).
• Implementation of Medicare requirements.
• Collection of accurate demographic information and interaction with physicians/office personnel as well as other hospital personnel (i.e., PTU, IOU, nursing units).
• Interact with hospital departments such as Insurance Verification, Financial Counseling, Utilization Review and Patient Business Services to ensure correct and timely reimbursement.

Skills

ICD-10/CPT-4/HCPCS

Auth submission

Medicare/Medi-Cal/ CCS

Public programs reimbursement

Medical terminology

Payor verification

State/Federal reimbursements

Communication skills

Typing 10-key

Coding basics

Job description

University of California in Los Angeles is seeking a Pre-Registration Representative to pre-register and pre-admit patients by phone or in person, review benefits, and coordinate with hospital departments to ensure accurate reimbursement.

The role includes collecting demographic information, implementing Medicare requirements, and interacting with physicians and staff to streamline admissions. Knowledge of ICD-10/CPT-4/HCPCS and payor verification is essential.