Remote Insurance Verification Specialist

University of Miami; Florida; Remote; USD 36,000 - 52,000; Full time

Job summary

The University of Miami UHealth at SoLé Mia is seeking a dedicated Insurance Verification Representative to work remotely. You will verify insurance eligibility, benefits, and obtain authorizations for outpatient services across the UHealth System.

Join a collaborative team that supports empathetic, patient-centered care and contributes to efficient revenue cycle operations while delivering high-quality service to patients and providers.

Qualifications

• High School Diploma or equivalent.
• Minimum 1 year of relevant work experience.
• Computer literate; EPIC scheduling and registration experience a plus.
• Strong written and oral communication skills.
• Able to work in a team environment.
• Graceful under pressure and stressful situations.
• Demonstrated knowledge of insurance, including authorization/referral guidelines and requirements.
• Bi-lingual knowledge a plus.
• Demonstrated ability to communicate effectively with physicians, customers, teammates and other staff.
• Ability to interact and assist patients of all ages, cultural backgrounds and with special needs.

Responsibilities

• Accounts are completed in a timely manner in support of patient satisfaction and allow for referral and authorization activities prior to the patient's date of service.
• Verification of eligibility and benefits via RTE in UChart, online insurance websites, telephone or other source of automated services.
• Adds or edits insurance information in UChart with accurate subscriber information, policy number, and claims address.
• Completes the checklist and documents co-pay.
• Creates referral if applicable, “Benefit only” or “Preauthorization,” and documents benefits information: deductible, co-insurance and out of pocket benefits.
• Meets productivity standards for assigned work queue and maintains 14 days out with minimum daily pending visits.
• Assists in educating and acts as a resource to patients, primary care and specialty care practices within the UHealth system and externally.
• Contacts Health Plans or Primary Care Physician offices to obtain authorization or referral for scheduled services according to guidelines.
• Obtains authorization for facility and provider for POS clinics and documents in UChart.
• Communicates with patients/departments regarding authorization status and any denials or redirections.
• Participates in process improvement initiatives (customer service).
• Provides customer service and assists patients and UHealth staff with insurance questions.
• Ensures patients are aware of financial clearance issues and educated on referral/authorization processes.
• Collaborates with Department and Patient Access teams for timely communication.
• Implements service recoveries and escalations as guided by supervisors.
• Performs other duties as assigned.

Skills

Teamwork

Communication skills

Bilingual (English/Spanish)

Education

High School Diploma or equivalent

Tools

EPIC scheduling and registration

Job description

The University of Miami UHealth at SoLé Mia is seeking a dedicated Insurance Verification Representative to work remotely. You will verify insurance eligibility, benefits, and obtain authorizations for outpatient services across the UHealth System.

Join a collaborative team that supports empathetic, patient-centered care and contributes to efficient revenue cycle operations while delivering high-quality service to patients and providers.