Job Description
Remote: Yes
Area of Interest: Patient Services
Salary Range: $33,000-$49,000
FTE/Hours per pay period: 1
Department: Financial Clearance
Shift: 8 - 4:30
Job ID: 159286
UnityPoint Health Information
Why UnityPoint Health?
Commitment to our Team – We’re proud to be recognized as a Top 150 Place to Work in Healthcare by Becker's Healthcare several years in a row for our commitment to our team members.
Culture – At UnityPoint Health, you matter. Come for a fulfilling career and experience a culture guided by uncompromising values and an unwavering belief in doing what's right for the people we serve.
Benefits – Our competitive Total Rewards program offers benefits options that align with your needs and priorities, no matter what life stage you’re in.
Caring is what we do, and it starts with our team members: expect paid time off, parental leave, 401K matching and an employee recognition program as we support you both personally and professionally.
You can only give your best when you feel your best, and we help you live well with dental and health insurance, paid holidays, short and long-term disability and more. We even offer pet insurance for your four-legged family members to give you peace of mind.
We strive to make things easier and more personal in health care to set us apart from the rest, and you can experience that commitment through early access to earned wages with Daily Pay, a tuition reimbursement program designed to help you further your career and adoption assistance to help you grow your family in the way that works for you.
Diversity, Equity and Inclusion Commitment – At UnityPoint Health, we honor the ways people are unique and embrace what brings us together. Our collective goal is to champion a culture of belonging where everyone feels valued and respected.
Development – We believe equipping you with support and development opportunities is an essential part of delivering a remarkable employment experience.
Community Involvement – Be an essential part of our core purpose—to improve the health of the people and communities we serve.
Hear more from our team members about why UnityPoint Health is a great place to work at https://dayinthelife.unitypoint.org
What are team member vaccine requirements?
As part of keeping our communities safe and healthy, all team members must be vaccinated for influenza and Tdap, provide proof of immunity to MMR and varicella, and be tested for tuberculosis. New hires must submit proof of vaccination or an approved exemption to begin work. If you have questions, please contact a recruiter or ask at any time during the interview process. UPH strongly recommends that all team members receive the updated COVID-19 vaccine, and at this time, UnityPoint Health – Meriter requires Covid-19 vaccination or an approved exemption.
Overview
We're looking for a Pre-authorization Specialist to join our team! In this role, you will obtain insurance eligibility, benefits, authorizations, pre-certifications and referrals for inpatient and outpatient, scheduled and non-scheduled visits. The Preauthorization Specialist is the primary documentation source for access and billing staff and works with insurance companies to appeal denials.
Location: This position is open to remote/work from home with strong preference for candidates residing within the UPH geographies of Iowa, Illinois, & Wisconsin.
Responsibilities
What you'll do:
Insurance Verification/Certification
Work with providers to assure that CPT and ICD-10 code is correct for procedure ordered and is authorized when necessary.
Completes eligibility check and obtain benefits though electronic means or via phone contact with insurance carriers or other agencies and when necessary/requested provide initial clinical documentation.
Initiates pre-certification process with physicians, PHO sites or insurance companies and obtains pre-cert/authorization numbers and adds them to the electronic health record and other pertinent information that secures reimbursement of account.
Perform follow-up calls as needed until verification/pre-certification process is complete.
Validates or update insurance codes and priority for billing accuracy.
Customer Services
Perform research to resolve customer problems
Collaborate with other departments to assist in obtaining pre-authorizations in a cross functional manner
Develop and implement prior authorization workflow to meet the needs of the customers.
Monitors and responds timely to all inquiries and communications.
Qualifications
What you'll need:
Education:
Requires minimally a High school diploma or GED.
Preferred - Two years of experience in a hospital patient access/patient accounts department, medical office/clinic or insurance company is desired.
Experience:
Previous customer service experience.
Experience interacting with patients and a working knowledge of third party payers.
Preferred - Prior experience with verification, and payer benefit and eligibility systems is preferred.
Knowledge/Skills/Abilities:
Ability to perform a variety of tasks, often changing assignments on short notice.
Must be adept at multi-tasking
Will be required to learn and work with multiple software/hardware products (sometimes concurrently) during the course of an average work day
Must possess excellent communication skills, verbal and listening.
Must be able to maintain a professional demeanor in stressful situations.
Adept with machinery typically found in a business office environment.
Mathematical aptitude to make contractual calculations and estimate patient financial obligations.
Able to build productive relationships with all contacts.
Must be able to perform data entry with speed and accuracy.
