NWIN Insurance Verification and Authorization Specialist, Full Time - Days

Be a part of a world-class academic healthcare system, UChicago Medicine- NWIN Crown Point, as a Insurance Verification & Authorization Specialist.

Under the general supervision of the Patient Access Manager, the insurance verification and authorization specialist will perform imperative duties and assume the responsibility for successful financial clearance of all scheduled patient services. Collaborates with Managed Care office to identify and interpret contracts governing patient care and provide timely response and resolution to patient inquiries. This includes securing the authorization, HMO referral and verifying benefits and will include bedded patients to ensure that the notification of admission is completed timely. This role with exhibit strong customer service skills, sophisticated communication and critical thinking skills in response to patient/care team inquiries and requests. Initiates problem solving to resolve patient inquiries by referring escalated concerns to appropriate sources for resolution when necessary.

Essential Functions

• Secure HMO referrals as necessary based on plan and service prior to the date of service
• Contact the insurance company via phone or portal to review benefits, understand authorization requirements, initiate the authorization, supply clinicals as needed, and follow up on authorization decision.
• Serve as the liaison between the providers, ancillary areas, utilization management, patient financial services, etc…
• Work collaboratively with our Mang partners to ensure timely screening for Medicaid coverage
• Accurate documentation in the EMR to support the account activity for financial clearance
• Assist with Epic work queues as assigned to correct any account deficiencies timely for billing.
• Contacts patients as necessary to obtain additional information as needed for accurate and timely billing
• Complete the notification of admission on bedded patients in accordance with the payer guidelines and department standards

Required Qualifications

• Associates’ degree in business, healthcare or related field and/or at least 3 years of Revenue Cycle experience with working knowledge of insurance and benefits required
• Knowledgeable in medical terminology is strongly preferred. Certificate is a plus.
• Knowledgeable in diagnostic and CPT coding and guidelines is strongly preferred
• 3 years of prior Epic experience required
• Knowledgeable in Microsoft Office applications strongly preferred
• High degree of initiative and problem solving ability
• Must be able to prioritize and execute multiple tasks, with accuracy, in a high-pressure environment
• Must be able to demonstrate and maintain a strong customer service orientation and a commitment to excellence in a changing environment
• Excellent communication skills and the ability to interact with people in a variety of contexts. Must respect patient confidentiality and interact with patients, families and other customers with courtesy, tact and discretion.
• Must be strongly invested in a team oriented dynamic environment and possess ability work independently, and make decisions in the best interest of the patient and the Hospitals
• Ability and willingness to cooperate with co-workers, supervisors and physicians to do whatever needs to be done in order to serve the patient
• Possess the flexibility to learn and incorporate new systems and processes as technology advances

Position Details

• Job Type/FTE: Full Time (1.0 FTE)
• Shift: Days, Monday-Friday 8:30am-5:00pm
• Unit/Department: Patient Access -Crown Point
• Work Location: Hybrid Remote (will need to be onsite on certain days)
• CBA Code: Non-union