Senior Insurance Verifier

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Work Shift

Day

Work Day(s)

Friday, Monday, Thursday, Tuesday, Wednesday

Shift Start Time

8:00 AM

4:30 PM

Regular

Children’s is one of the nation’s leading children’s hospitals. No matter the role, every member of our team is an essential part of our mission to make kids better today and healthier tomorrow. We’re committed to putting you first, and that commitment is at the heart of our company culture: People first. Children always. Find your next career opportunity and make a difference doing what you love at Children’s.

Serves as expert/senior team member while participating in authorization and pre-certification of healthcare services to prevent claims denial and/or appointment cancellation/rescheduling due to authorization issues (e.g., ensuring referring physician obtains prior authorization from insurance company for all scheduled healthcare procedures within assigned department/area). Provides ongoing communication and training to physician offices, patients/families, and others to resolve authorization- related departmental issues. Coordinates changes in process and provides learning materials and resources. Proactively identifies and communicates financial resources available if health plan does not include coverage for services. Coordinates counseling services with Financial Counseling. Collaborates with Patient Financial Services (PFS) department regarding denied claims. Initiates and performs revenue cycle activities required for insurance verification, authorization, and pre-registration. Works collaboratively with team members to provide quality service. Supports the leadership team as needed.

Experience

• 3 years of healthcare insurance verification experience, including authorizations
• Epic experience

Preferred Qualifications

• Bachelor's degree
• Experience in a pediatric hospital
• Epic SuperUser

Education

• High school diploma or equivalent

Certification Summary

• Certified Healthcare Access Associate Certification (CHAA) within six (6) months of employment as Senior Insurance Verifier

Knowledge, Skills, and Abilities

• Working knowledge of medical terminology
• Demonstrated ability to multitask and problem-solve
• Ability to work independently in a changing environment and handle stressful situations.
• Ability to read, analyze and interpret medical and supply publications, technical procedures and/or training tools
• When applicable, specialized focus on assignment or location, must be able to analyze in depth account review including but not limited to, denial management, clinical follow up, <