Requirements

Two (2) years of related experience in the healthcare industry with an emphasis on medical claims
High school diploma or GED is required
Some knowledge of patient billing or collection/reimbursement procedures
Proficient in Microsoft Office
Verify patient benefits and insurance eligibility to update registration and coverage information
Responsible for telephone eligibility support
Handle incoming patients and Clinic questions, in regard to patient copays, deductible and coinsurance coverage and eligibility
Responsible for adding and updating all commercial and governmental payers
Obtaining referral/authorization for scheduled patients
Review Charge review for registration errors and update for accurate and timely billing
Reviews new and follow-up patient registration, obtains and manages referrals, and advises on co-pays and deductibles
Contacts PCP and/or Clinic to coordinate and obtain accurate and current referral documentation
Coordinates with UHS referral team and has in-depth knowledge of registration access tools
Effectively navigates between multiple verification tools to obtain thorough eligibility and benefits material
Meet current production standards set by the management team to resolve outstanding claims and maintain a healthy accounts receivable
Completes all other duties as assigned

Responsibilities

Performs insurance verification duties to obtain primary insurance data for use in determining patient’s eligibility for visits, by verifying insurance, correcting patient demographics, obtaining referrals as needed
Participate in quality control and solution recommendation to include notification to management team of process issues
Handle incoming patients and Clinic questions, in regard to patient copays, deductible and coinsurance coverage and eligibility
Obtain referral/authorization for scheduled patients
Review Charge review for registration errors and update for accurate and timely billing
Reviews new and follow-up patient registration, obtains and manages referrals, and advises on co-pays and deductibles
Contacts PCP and/or Clinic to coordinate and obtain accurate and current referral documentation, once confirming patients have established care
Coordinates with UHS referral team and has in-depth knowledge of both registration access tools
Effectively navigates between multiple verification tools to obtain thorough eligibility and benefits material
Meet current production standards set by the management team to resolve outstanding claims and maintain a healthy accounts receivable
Completes all other duties as assigned

Desired Qualifications

Insurance Verification Specialist

UTHealth Houston