POSITION SUMMARY:
Verifies insurance coverage profit info and obtains Authorization/ Precertification, previous to the affected person’s go to or scheduled admission, or instantly following admission. Help in figuring out issues and ensures that the insurance is correct on the affected person account. Assures insurance info and applicable referrals have been utterly and precisely obtained.
Further Abstract Particular to Job
POSITION KEY ACCOUNTABILITIES:
1. Verifies insurance coverage advantages for brand spanking new and returning sufferers with carriers and employers.
2. Assures all insurance info has been utterly and precisely obtained. Paperwork all pertinent insurance info. Paperwork info given or acquired to help actions taken on insurance expenses or referral points.
three. Identifies particular coverage clauses or pre-present circumstances and verifies efficient date of insurance policies.
four. Educates sufferers and households on insurance points. Communicates affected person’s fiscal duty in knowledgeable method.
5. Notifies applicable work models of affected person’s insurance protection, authorizations, or standing.
6. Identifies all sufferers with out third celebration monetary advantages and directs them for monetary counseling based on Monetary Counseling and Income Cycle insurance policies and procedures.
7. Receives and critiques UT-H Health Science Center’ Managed Care contracts to know the contract provisions. Interprets managed care contracts for insurance protection.
eight. Supplies help to Income Cycle work models and different work models as assigned.
9. Different duties as assigned.
Organizational Necessities
MINIMUM EDUCATION:
Highschool diploma or equal required; some school most popular.
MINIMUM EXPERIENCE:
6 months of associated expertise required.
Departmental Necessities/Preferences
Source: https://www.businessnetworkingorangecounty.com/insurance-authorization-verification-specialist-i-ut-health-science-center-at-houston-houston-tx/
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