Insurance Specialist

University of Colorado Anschutz Medical Campus

School of Medicine | Department of Psychiatry

Job Title: Insurance Specialist

Position: #00836606 – Requisition: #37254

Job Summary:

The University of Colorado Anschutz Medical Campus has an opening for a full-time University Staff (unclassified) Insurance Specialist in the Department of Psychiatry. Clinics are located in Aurora Colorado at the School of Medicine. Programs in the various clinics include traditional psychiatric and psychological outpatient treatment; support and therapy groups, trauma care for adolescents and adults; student resident mental health; gender responsive services as well as specialty services for Women going through Cancer Therapy and Menopause.

This position will report to and serve under the supervision of the Supervisor and Business Services Manager at the Department of Psychiatry. This position is responsible for managing various patient registration, revenue cycle and administrative duties for any assigned clinics. While providing those duties, they should endeavor to provide excellent customer service, leaving a positive impression on patients, providers and staff. They will be expected to perform routine insurance reviews, prior authorization requests, obtain and verify patient demographics, train clinic PSRs in all aspects of registrations, provide routine insurance updates, train insurance staff, and act as the subject matter expert for their assigned area. Additionally, this individual will be responsible for troubleshooting patient billing issues in coordination with CU Medicine. They will primarily focus on their assigned area but will also be expected to provide coverage to other clinical areas, as needed.

Key Responsibilities:

• Evaluate and communicate patient’s potential financial liability directly to the patient prior to medical services being rendered based on insurance verification data and medical cost estimates.
• Obtain insurance authorization and pre-certification for behavioral health services. Includes obtaining and documenting covered and non-covered benefits, plan type, co-payments, co-insurance, out of pocket, and deductible amounts and determining contract and benefit eligibility. Contact insurance companies as needed.
• Review, process, and audit the medical necessity for each patient behavioral health treatment and documentation insurance authorization including review of CPT/ICD diagnosis codes.
• Work as a patient advocate and functions as a liaison between the patient and payer to answer reimbursement questions and avoid insurance delays.
• Communicate with patient access and medical staff to inform them of any restrictions or special requirements in accordance with insurance plans.
• Update coding/payer guidelines for clinical staff and adheres to CU Medicine guidelines with obtaining authorization. Track pathways and performs various other business office functions on an as needed basis.
• Identifies and refers problematic workflow trends to Supervisor for evaluation and solution.

Work Location:

Hybrid – this role is eligible for a hybrid schedule on campus and as needed for in-person meetings.

Why Join Us: