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Veterans Affairs, Veterans Health Administration
Ohio
Veterans Affairs, Veterans Health Administration
Ohio
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Details
Posted: 24-Feb-23
Location: Cincinnati, Ohio
Salary: Open
Categories:
Allied Health
Internal Number: 140524
Rep II Insurance Verify - Neurology - Days - 40 Hours/Week
Expected Starting Salary Range: 18.83 - 22.95
SUBFUNCTION DEFINITION: Prepares and forwards patient claims to appropriate third-party payers. Analyzes and reviews claims to ensure that payer-specific billing requirements are met. Follows up on billing, determines and applies appropriate adjustments, answers inquiries and updates accounts as necessary.
REPRESENTATIVE RESPONSIBILITIES
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.
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.
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.
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.
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.
Qualifications
EDUCATION/EXPERIENCE
Required:
Preferred:
Unique Skills:
Cincinnati Children's is proud to be an Equal Opportunity Employer that values and treasures Diversity, Equity, and Inclusion. We are committed to creating an environment of dignity and respect for all our employees, patients, and families (EEO/AA).
About Cincinnati Children's Hospital Medical Center
At Cincinnati Children’s, we come to work with one goal: to make children’s health better. We believe in a 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.
More Jobs from This Employer
https://jobboard.neohospitals.org/jobs/18244615/rep-ii-insurance-verify
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