Insurance Verification And Authorization Specialist (Hybrid)

Join a world-class academic healthcare system,UChicago MedicineCrown Point, located in Crown Point, Indiana. UChicago Medicine is an integrated academic and community health system with multiple primary medical facilities within the surrounding suburbs of Chicago.  UChicago Medicine, Crown Point is a new two-story, 130,000-square-foot multispecialty care center and micro-hospital in Northwest Indiana for what will be the academic health system's largest off-site facility and its first freestanding building in Indiana.  It is anticipating an opening in Spring 2024.

The Crown Point care center will include:

• A micro-hospital with an eight-bed emergency department and a short-stay inpatient unit
• A comprehensive cancer center with infusion therapy as well as radiation, medical and surgical oncology
• An imaging center with MRI, CT, PET, X-ray and ultrasound capabilities
• An outpatient surgery center
• Laboratory services
• Medical offices with access to UChicago Medicine’s physicians and specialists, including those in cancer care, cardiology, digestive diseases, orthopaedics, neurosciences, pediatrics, primary care, surgical specialties, transplant care and women’s health

Job Summary:

• Under the general supervision of the Patient Access Manager, the Insurance Verification and Authorization Specialist will perform imperative duties and assume the responsibility for successful financial clearance of all scheduled patient services.

• Collaborates with Managed Care office to identify and interpret contracts governing patient care and provide timely response and resolution to patient inquiries.

  • This includes securing the authorization, HMO referral and verifying benefits and will include bedded patients to ensure that the notification of admission is completed timely.

• This role with exhibit strong customer service skills, sophisticated communication and critical thinking skills in response to patient/care team inquiries and requests.

• Initiates problem solving to resolve patient inquiries by referring escalated concerns to appropriate sources for resolution when necessary

Essential Job Functions:  

• Insurance Verification:
  • Secure HMO referrals as necessary based on plan and service prior to the date of service
  • Contact the insurance company via phone or portal to review benefits, understand Authorization requirements, initiate the authorization, supply clinicals as needed, and follow up on authorization decision.
• Patient Authorization
  • Serve as the liaison between the providers, ancillary areas, utilization management, patient financial services, etc…
  • Work collaboratively with our Mang partners to ensure timely screening for Medicaid coverage
  • Accurate documentation in the EMR to support the account activity for financial clearance
• Billing:
  • Assist with Epic work queues as assigned to correct any account deficiencies timely for billing.
  • Contacts patients as necessary to obtain additional information as needed for accurate and timely billing
• Admissions:
  • Complete the notification of admission on bedded patients in accordance with the payer guidelines and department standards.
• General:
  • Adheres to established standard work and utilizes communication tools to ensure consistent and exceptional patient care.
  • Completes additional responsibilities as directed by management

Qualifications: 

• Associates’ degree in business, healthcare or related field and/or at least 3 years of Revenue Cycle experience with working knowledge of insurance and benefits required
• 3 years of prior Epic experience required
• Knowledgeable in Microsoft Office applications strongly preferred
• Knowledgeable in diagnostic and CPT coding and guidelines is strongly preferred
• Knowledgeable in medical terminology is strongly preferred. Certificate is a plus
• High degree of initiative and problem solving ability
• Must be able to prioritize and execute multiple tasks, with accuracy, in a high-pressure environment
• Must be able to demonstrate and maintain a strong customer service orientation and a commitment to excellence in a changing environment
• Excellent communication skills and the ability to interact with people in a variety of contexts. Must respect patient confidentiality and interact with patients, families and other customers with courtesy, tact and discretion.
• Must be strongly invested in a team oriented dynamic environment and possess ability work independently, and make decisions in the best interest of the patient and the Hospitals
• Ability and willingness to cooperate with co-workers, supervisors and physicians to do whatever needs to be done in order to serve the patient
• Possess the flexibility to learn and incorporate new systems and processes as technology advances

Position Details

• Job Type: Full Time (1.0FTE)
• Shift: Days- 8am - 5pm (Hybrid Remote) M-F 
• Office Location when onsite is required: NWIN - Crown Point Location (Set to open spring 2024), / Training will be at various locations
• Unit: Revenue Cycle- Patient Access Services
• CBA Code: Non-Union

Must comply with UCMC’s COVID-19 Vaccination requirement as a condition of employment. If you have already received the vaccination, you must provide proof as part of the pre-employment process. This is in addition to your compliance with the Flu Vaccination requirement as well. Medical and religious exemptions will be considered consistent with applicable law. Lastly, a pre-employment physical, drug screening, and background check are also required for all employees prior to hire.

We’ve been at the forefront of medicine since 1899. We provide superior healthcare with compassion, always mindful that each patient is a person, an individual. To accomplish this, we need employees with passion, talent and commitment… with patients and with each other. We’re in this together: working to advance medical innovation, serve the health needs of the community, and move our collective knowledge forward. If you’d like to add enriching human life to your profile, The University of Chicago Medicine is for you. Here at the forefront, we’re doing work that really matters. Join us. Bring your passion.

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Bring your career to the next level at a hospital that is thriving; from patient satisfaction to employee engagement, we are at the Forefront of Medicine. Take advantage of all we have to offer and #BringYourPassiontotheForefront.

University of Chicago Medicine is growing; discover how you can be a part of this pursuit of excellence at: www.uchospitals.edu/jobs 

The University of Chicago Medical Center is an equal opportunity employer.  We evaluate qualified applicants without regard to race, color, ethnicity, ancestry, sex, sexual orientation, gender identity, marital status, civil union status, parental status, religion, national origin, age, disability, veteran status and other legally protected characteristics.