UnityPoint Health
Preauthorization Specialist
UnityPoint Health, Rock Island, Illinois, United States, 61202
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.Why UnityPoint Health?Commitment to our Team Weve been named a Top 150 Place to Work in Healthcare 2022 by Beckers Healthcare 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 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 youre in.Diversity, Equity and Inclusion Commitment Were committed to ensuring you have a voice that is heard regardless of role, race, gender, religion, or sexual orientation.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 purposeto improve the health of the people and communities we serve.Visit us at UnityPoint.org/careers to hear more from our team members about why UnityPoint Health is a great place to work. 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 2023-2024 COVID-19 vaccine, and at this time, UnityPoint Health Meriter requires Covid-19 vaccination or an approved exemption.Responsibilities:What you'll do:Insurance Verification/CertificationWork 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 ServicesPerform research to resolve customer problemsCollaborate with other departments to assist in obtaining pre-authorizations in a cross functional mannerDevelop 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-taskingWill be required to learn and work with multiple software/hardware products (sometimes concurrently) during the course of an average work dayMust 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.
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.Why UnityPoint Health?Commitment to our Team Weve been named a Top 150 Place to Work in Healthcare 2022 by Beckers Healthcare 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 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 youre in.Diversity, Equity and Inclusion Commitment Were committed to ensuring you have a voice that is heard regardless of role, race, gender, religion, or sexual orientation.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 purposeto improve the health of the people and communities we serve.Visit us at UnityPoint.org/careers to hear more from our team members about why UnityPoint Health is a great place to work. 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 2023-2024 COVID-19 vaccine, and at this time, UnityPoint Health Meriter requires Covid-19 vaccination or an approved exemption.Responsibilities:What you'll do:Insurance Verification/CertificationWork 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 ServicesPerform research to resolve customer problemsCollaborate with other departments to assist in obtaining pre-authorizations in a cross functional mannerDevelop 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-taskingWill be required to learn and work with multiple software/hardware products (sometimes concurrently) during the course of an average work dayMust 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.