%3Cdiv class=%22oj-form-control block__field-rtfValue %22 style=%22-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:%26quot;Open Sans%26quot;, %26quot;Segoe UI%26quot;, Frutiger, %26quot;Frutiger Linotype%26quot;, %26quot;Dejavu Sans%26quot;, %26quot;Helvetica Neue%26quot;, Arial, sans-serif;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin-bottom:5px;orphans:2;padding-bottom:5px;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;vertical-align:middle;white-space:normal;widows:2;word-spacing:0px;%22 data-bind=%22attr: {id: %24data.name + %27-value%27, formFieldId: %24data.name},%0A html: %24component.getFieldValue(%24data)%22 id=%22descriptionExt-value%22 formfieldid=%22descriptionExt%22%3E%3Cp style=%22margin:0px 0px 12px;%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:14px;%22%3E%3Cstrong%3EWe are looking for an Insurance Authorization Verifications Specialist III to join our Revenue Cycle team. In this role, you will manage the daily insurance eligibility and verification tasks for assigned providers, including confirming benefit details and securing authorizations or pre-certifications prior to patient visits or admissions, or immediately afterward. You will help identify and resolve issues, ensure insurance information is accurately reflected in patient accounts, and confirm that all necessary referrals are properly completed. Success in this position requires maintaining productivity levels, meeting UTHN-assigned performance metrics, and consistently demonstrating our team’s core values. We are a group passionate about creating positive patient experiences, and we seek a team member who shares our commitment to compassionate care. This position offers opportunities for continued growth and development within a comprehensive, multispecialty and university practices.%3C/strong%3E%3C/span%3E%3C/p%3E%3C/div%3E%3Cp%3E%3Cstrong%3EWhat we do here changes the world.%3C/strong%3E UTHealth Houston is Texas’ resource for healthcare education, innovation, scientific discovery, and excellence in patient care. That’s where you come in.%3C/p%3E%3Cp%3E%3Cstrong%3EOnce you join us you won%27t want to leave.%3C/strong%3E It’s because we reward our team for the excellent service they provide. Our total rewards package includes the benefits you’d expect from a top healthcare organization (benefits, insurance, etc.), plus: %26nbsp;%3C/p%3E%3Cul%3E%3Cli%3E100% paid medical premiums for our full-time employees %26nbsp;%3C/li%3E%3Cli%3EGenerous time off (holidays, preventative leave day, both vacation and sick time – all of which equates to around 37-38 days per year)%26nbsp;%3C/li%3E%3Cli%3EThe longer you stay, the more vacation you’ll accrue!%26nbsp;%3C/li%3E%3Cli%3ELongevity Pay (Monthly payments after two years of service)%26nbsp;%3C/li%3E%3Cli%3EBuild your future with our awesome retirement/pension plan!%26nbsp;%3C/li%3E%3C/ul%3E%3Cp%3E%3Cstrong%3EWe take care of our employees!%3C/strong%3E As a world-renowned institution, our employees’ wellbeing is important to us. We offer work/life services such as...%26nbsp;%3C/p%3E%3Cul%3E%3Cli%3EFree financial and legal counseling%26nbsp;%3C/li%3E%3Cli%3EFree mental health counseling services%26nbsp;%3C/li%3E%3Cli%3EGym membership discounts and access to wellness programs%26nbsp;%3C/li%3E%3Cli%3EOther employee discounts including entertainment, car rentals, cell phones, etc.%26nbsp;%3C/li%3E%3Cli%3EResources for child and elder care%26nbsp;%3C/li%3E%3Cli%3EPlus many more!%26nbsp;%3C/li%3E%3C/ul%3E%3Cp%3E%3Cstrong%3EPosition Summary:%3C/strong%3E%3C/p%3E%3Cp%3EWorks to achieve team and departmental goals by serving as a team lead for the Insurance Verification team responsible for verifying insurance policy benefit information and obtaining Authorization / Precertification, prior to the patient%27s visit or scheduled admission, or immediately following admission. Identifies problems and ensures that the insurance is accurate on the patient account. Assures insurance information and appropriate referrals have been completely and accurately obtained.%3C/p%3E%3Cp%3E%3Cstrong%3EPosition Key Accountabilities:%3C/strong%3E%3C/p%3E%3Cul%3E%3Cli%3EVerifies insurance policy benefits for new and returning patients with carriers and employers.%3C/li%3E%3Cli%3EAssures all insurance information has been completely and accurately obtained.%3C/li%3E%3Cli%3EDocuments all pertinent insurance information.%3C/li%3E%3Cli%3EDocuments information given or received to support actions taken on insurance charges or referral issues.%3C/li%3E%3Cli%3EIdentifies complex special policy clauses or pre-existing conditions and verifies effective date of policies.%3C/li%3E%3Cli%3EMentors and serves as a resource for less experienced staff.%3C/li%3E%3Cli%3EEducates patients and families on insurance issues.%3C/li%3E%3Cli%3ECommunicates patient%27s fiscal responsibility in a professional manner.%3C/li%3E%3Cli%3EEnsures that accurate notification of patient%27s insurance coverage, authorizations, or status is provided to all involved work units and departments.%3C/li%3E%3Cli%3EIdentifies all patients without third party financial benefits and directs them for financial counseling according to Financial Counseling and Revenue Cycle policies and procedures.%3C/li%3E%3Cli%3EReceives and reviews UT-H Health Science Center Managed Care contracts to understand the contract provisions.%3C/li%3E%3Cli%3EInterprets managed care contracts for insurance coverage.%3C/li%3E%3Cli%3EProvides support to Revenue Cycle work units and other work units as assigned.%3C/li%3E%3Cli%3EPerforms other duties as assigned.%3C/li%3E%3C/ul%3E
Certification/Skills:
Minimum Education:
High School Diploma or equivalent required
Graduate of an education program approved by the credentialing body for the required credential(s) required
Associate's Degree preferred
Minimum Experience:
5 years of medical office experience required with good understanding of third party reimbursement procedures required
Experience in working with various insurance companies including both governmental and commercial insurance plans required
Physical Requirements:
Exerts up to 20 pounds of force occasionally and/or up to 10 pounds frequently and/or a negligible amount constantly to move objects.
Security Sensitive:
This position is a security-sensitive position pursuant to Texas Education Code §51.215 and Texas Government Code §411.094. To the extent that a position requires the holder to research, work on, or have access to critical infrastructure as defined in Texas Business and Commerce Code §117.001(2), the ability to maintain the security or integrity of the infrastructure is a minimum qualification to be hired for and to continue to be employed in that position. Personnel in such positions, and similarly situated state contractors, will be routinely reviewed to determine whether things such as criminal history or continuous connections to the government or political apparatus of a foreign adversary might prevent the applicant, employee, or contractor from being able to maintain the security or integrity of the infrastructure. A foreign adversary is a nation listed in 15 C.F.R. §791.4.
Residency Requirement:
Employees must permanently reside and work in the State of Texas.