REMOTE - Senior Insurance Authorization Verification Specialist (Rev Cycle)

　　Location: Houston, Texas

　　Category: Professional/Managerial

　　McGovern Medical School at UTHealth Houston

　　Requisition #: 24000096

　　What we do here changes the world. UTHealth Houston is Texas’ resource for healthcare education, innovation, scientific discovery, and excellence in patient care. That’s where you come in.

　　This position is REMOTE!

　　Must be located in TEXAS.

　　Once you join us you won't want to leave. It’s because we reward our team for the excellent service they provide. Our total rewards package includes the benefits you’d expect from a top healthcare organization (benefits, insurance, etc.), plus:

　　100% paid medical premiums for our full-time employees

　　Generous time off (holidays, preventative leave day, both vacation and sick time – all of which equates to around 37-38 days per year)

　　The longer you stay, the more vacation you’ll accrue!

　　Longevity Pay (Monthly payments after two years of service)

　　Build your future with our awesome retirement/pension plan!

　　We take care of our employees! As a world-renowned institution, our employees’ wellbeing is important to us. We offer work/life services such as...

　　Free financial and legal counseling

　　Free mental health counseling services

　　Gym membership discounts and access to wellness programs

　　Other employee discounts including entertainment, car rentals, cell phones, etc.

　　Resources for child and elder care

　　Plus many more!

　　Position Summary:

　　Works to achieve team and departmental goals by serving as a team lead for the Insurance Verification team responsible for verifying insurance policy benefit information and obtaining Authorization / Precertification, prior to the patient’s visit or scheduled admission, or immediately following admission. Identifies 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 complex special policy clauses or pre-existing conditions and verifies effective date of policies.

　　Mentors and serves as a resource for less experienced staff.

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

　　Ensures that accurate notification of patient’s insurance coverage, authorizations, or status is provided to all involved work units and departments.

　　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.

　　Performs other duties as assigned.

　　Certification/Skills:

　　Excellent communication skills, both oral and written.

　　Understanding of MS Office applications with an emphasis in Excel. Good math and basic clerical skills.

　　Proven ability to effectively problem solve.

　　Must have skill in establishing and maintaining effective working relationships with other employees, patients, governmental and commercial payer representatives.

　　Minimum Education:

　　High school or equivalent required. Graduate from a vocational business school in job related field or an Associate’s Degree preferred.

　　Minimum Experience:

　　Five (5) years medical office experience required with good understanding of third party reimbursement procedures. Must have experience in working with various insurance companies including both governmental and commercial insurance plans.

　　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 job class may contain positions that are security sensitive and thereby subject to the provisions of Texas Education Code § 51.215

　　Residency Requirement:

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

　　If you are looking for a great healthcare career in Houston, visithttp://go.uth.edu/careers!

　　University of Texas Health Science Center at Houston (UTHealth)

　　Established in 1972 by The University of Texas System Board of Regents, The University of Texas Health Science Center at Houston (UTHealth) is Houston’s Health University and Texas’ resource for health care education, innovation, scientific discovery and excellence in patient care. The most comprehensive academic health center in the UT System and the U.S. Gulf Coast region, UTHealth Houston is home to schools of biomedical informatics, biomedical sciences, dentistry, nursing and public health and the John P. and Kathrine G. McGovern Medical School. UTHealth Houston includes The University of Texas Harris County Psychiatric Center, as well as the growing clinical practices UT Physicians, UT Dentists and UT Health Services. The university’s primary teaching hospitals are Memorial Hermann-Texas Medical Center, Children’s Memorial Hermann Hospital and Harris Health Lyndon B. Johnson Hospital.

　　UTHealth Benefits

　　UTHealth Houston offers a comprehensive and competitive benefits package. For more information on our benefits programs please refer to the UTHealth Houston Office of Benefits Website.

　　https://www.uth.edu/benefits/

　　Equal Employment Opportunity Statement

　　UTHealth Houston is committed to providing equal opportunity in all employment-related activities without regard to race, color, religion, sex, sexual orientation, national origin, age, disability, genetic information, gender identity or expression, veteran status or any other basis prohibited by law or university policy. Reasonable accommodation, based on disability or religious observances, will be considered in accordance with applicable law and UTHealth Houston policy. The University maintains affirmative action programs with respect to women, minorities, individuals with disabilities, and eligible veterans in accordance with applicable law.

　　UTHealthHoustonhas adopted a policy consistent with CMS regulations to protect our patients and university community from exposure to COVID-19. This policy affects all employees, residents, fellows, students, contractors, new hires, visiting scholars program participants, adjunct faculty, and volunteers who work, train, or collaborate at the John S. Dunn Behavioral Science Center.

　　In addition, all UTHealthHouston​​​​​​​employees who are assigned to work at a location that is subject to the affiliated partner’s hospital, clinical offices, or agency are required to abide by UTHealth’sHoustonrules and regulations, as well as the affiliate’s rules and regulations, including COVID-19 vaccination and safety requirements.

　　Work location is based on the needs of the department and may be adjusted.