Insurance Verification Representative II
Cincinnati Children'sAbout the role
JOB RESPONSIBILITIES
Problem Resolution - Serve as first level problem resolution for both internal and external customers. Initiate calls to appropriate parties both internal and external to resolve issues. Escalate to appropriate staff regarding system errors, recurring divisional problems/errors identified within work queues or reports. Work with team to suggest/recommend changes to systems or work processes.
Collaboration - Serve as a liaison between Hospital/Physicians Billing Service, Admitting, Outpatient Surgery, Outpatient Department, Patient Financial Services, Utilization Review and other Cincinnati Children's departments. Multiple division support; cross trained in order to work insurance pre-authorization for multiple divisions. Participate in Department Meetings to share payer trends related to Pre-Authorizations.
Quality Improvement - Maintain and update departmental system, including templates and payer and physician information. Identify opportunity for improvement in Departmental processes and communicate findings to Management for evaluation.
Productivity - Work independently and/or collaboratively with team to efficiently handle work volume and queues to meet or exceed productivity standards. Accurately collect/verify insurance information and demographics, obtaining insurance authorization and entering the information into the required systems.
Pre-Authorization - Utilize systems including medical records to obtain needed clinical support to efficiently confirm receipt of or to obtain pre-authorization for scheduled services and medications that require a higher level of clinical knowledge. Collaborate with internal and external resources regarding specific authorizations scenarios. Work with team to make contact with families prior to patient scheduled visits and/or services to confirm insurance eligibility, referrals/authorizations with minimal stress to the family/patient.
JOB QUALIFICATIONS
High school diploma or equivalent
2+ years of work experience in a related job discipline
Primary Location
Remote
Schedule
Full time
Shift
Day (United States of America)
Department
Centralized Pre-authorization
Employee Status
Regular
FTE
1
Weekly Hours
40
*Expected Starting Pay Range
*Annualized pay may vary based on FTE status
$20.57 - $25.72
About Us
At Cincinnati Children’s, we come to work with one goal: to make children’s health better. We believe in a holistic team approach, both in caring for patients and their families, and in advancing science and discovery. We strive to do better and find energy and inspiration in our shared purpose. If you want to be the best you can be, you can do it at Cincinnati Children’s.
Cincinnati Children's is:
Recognized by U.S. News & World Report as a top 10 best Children's Hospitals in the nation for more than 15 years
Consistently among the top 3 Children's Hospitals for National Institutes of Health (NIH) Funding
Recognized as one of
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