Insurance Specialist II - Patient Financial/Access Services
UT Southwestern Medical CenterAbout the role
Description
WHY UT SOUTHWESTERN?
With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and research center, we strive to provide the best possible care, resources, and benefits for our valued employees. Ranked as the number 1 hospital in Dallas-Fort Worth according to U.S. News & World Report, we invest in you with opportunities for career growth and development to align with your future goals. Our highly competitive benefits package offers healthcare, PTO and paid holidays, on-site childcare, wage, merit increases and so much more. We invite you to be a part of the UT Southwestern team where you'll discover a culture of teamwork, professionalism, and a rewarding career!
BENEFITS
UT Southwestern is proud to offer a competitive and comprehensive benefits package to eligible employees. Our benefits are designed to support your overall wellbeing, and include:
- PPO medical plan, available day one at no cost for full-time employee-only coverage
- 100% coverage for preventive healthcare-no copay
- Paid Time Off, available day one
- Retirement Programs through the Teacher Retirement System of Texas (TRS)
- Paid Parental Leave Benefit
- Wellness programs
- Tuition Reimbursement
- Public Service Loan Forgiveness (PSLF) Qualified Employer
- Learn more about these and other UTSW employee benefits!
Work Schedule: 8:30am-5pm, Monday-Friday. This role is primarily remote; however, candidates must reside in the Dallas-Fort Worth metroplex to attend occasional on-site meetings and training sessions.
EXPERIENCE AND EDUCATION
Required
- Education
High School diploma or equivalent
- Experience
3 years of benefit verification/authorization experience or equivalent and
1 year Customer Service/Customer service and
3 years Clinical / Medical/Precertification/Predetermination/Authorizations/Verification and
4 years end user Desktop Tools, Microsoft Outlook, Microsoft Word, Office Equipment/Fax/Copier and
1 year of EPIC experience.
JOB DUTIES
- Monitors the correct patient work queue to determine accounts needing verification.
- Coordinates with physician's office and/or ancillary department regarding additional information needed to obtain pre-certification and insurance benefits.
- Maintains department productivity standards.
- Pre-registers patient cases by entering complete and accurate information prior to patient's arrival. Identifies and verifies all essential information pertaining to intake, insurance verification/eligibility, and precertification on all applicable patient accounts. Revises information in computer systems as needed.
- Documents pertinent information and efforts in computer system based upon department documentation standards.
- Verifies insurance information by utilizing insurance websites or calling insurance companies to verify active coverage, deductible, copay and any other specific information needed in accordance to the verification guidelines.
- Create and call patients with cost estimate for scheduled appointments.
- Ensures all exams are scheduled with proper patient class and clinical indicators and coding nomenclature.
- Monitors, verifies, transcribes faxed documents to select insurance companies regarding authorization requests
- Accurately monitors, reviews, data enters and processes authorizations and validate that the requests are accurate, within the required timeline, and in compliance with the applicable insurance guidelines
- Follows strict quality measures of documents scanned into the electronic medical record and/or submitted to applicable insurance
- Protects the p
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