We are looking for an Insurance Authorization Verifications Specialist II to join our Revenue Cycle team. In this role, you will manage the daily insurance eligibility and verification tasks for assigned providers, including confirming benefit details and securing authorizations or precertifications prior to patient visits or admissions, or immediately afterward. You will help identify and resolve issues, ensure insurance information is accurately reflected in patient accounts, and confirm that all necessary referrals are properly completed. Success in this position requires maintaining productivity levels, meeting UTHN-assigned performance metrics, and consistently demonstrating our team's core values. We are a group passionate about creating positive patient experiences, and we seek a team member who shares our commitment to compassionate care. This position offers opportunities for continued growth and development within a comprehensive, multispecialty and university practices.

Position Summary:

Verifies insurance policy benefit information and obtains Authorization/ Precertification, prior to the patient's visit or scheduled admission, or immediately following admission. Assist in identifying problems and ensures that the insurance is accurate on the patient account. Assures insurance information and appropriate referrals have been completely and accurately obtained.

Position Key Accountabilities:

Verifies insurance policy benefits for new and returning patients with carriers and employers.

Assures all insurance information has been completely and accurately obtained. Documents all pertinent insurance information. Documents information given or received to support actions taken on insurance charges or referral issues.

Identifies special policy clauses or pre-existing conditions and verifies effective date of policies.

Educates patients and families on insurance issues. Communicates patient's fiscal responsibility in a professional manner.

Notifies appropriate work units of patient's insurance coverage, authorizations, or status.

Identifies all patients without third party financial benefits and directs them for financial counseling according to Financial Counseling and Revenue Cycle policies and procedures.

Receives and reviews UT-H Health Science Center' Managed Care contracts to understand the contract provisions. Interprets managed care contracts for insurance coverage.

Provides support to Revenue Cycle work units and other work units as assigned.

Other duties as assigned.

Minimum Education:

High school diploma or equivalent required; some college preferred.

Minimum Experience:

Three years of related experience required.

Physical Requirements:

Exerts up to 20 pounds of force occasionally and/or up to 10 pounds frequently and/or a negligible amount constantly to move objects.

Security Sensitive:

This position is a security-sensitive position pursuant to Texas Education Code §51.215 and Texas Government Code §411.094. To the extent that a position requires the holder to research, work on, or have access to critical infrastructure as defined in Texas Business and Commerce Code §117.001(2), the ability to maintain the security or integrity of the infrastructure is a minimum qualification to be hired for and to continue to be employed in that position. Personnel in such positions, and similarly situated state contractors, will be routinely reviewed to determine whether things such as criminal history or continuous connections to the government or political apparatus of a foreign adversary might prevent the applicant, employee, or contractor from being able to maintain the security or integrity of the infrastructure. A foreign adversary is a nation listed in 15 C.F.R. §791.4.

Residency Requirement:

Employees must permanently reside and work in the State of Texas.