• Develops effective relationships with insurance company representatives.
• Utilize ICD-10 and CPT/HCPCS codes to ensure proper authorization for procedure and claims payment.
• Responsible for explaining benefits, the billing process and financial responsibilities to patients.
• Responsible for obtaining complete and accurate insurance information, benefit verification, accurately interpreting benefit plans and investigating pertinent details. Notifies supervisor of know or potential issues.
• Responsible for obtaining and communication pre-authorization as needed per insurance company requirements.
• Responsible for tracking, obtaining and extending authorizations from various carriers in a timely manner.
• Scan all insurance verification and authorizations into system and communicate insurance information to pertinent staff.
• Independently works from NaviNet, PEAR, Availity, Passport and other web portals.
• Input new patient information and update information as needed, maintain patient demographic information.
• Provides detailed, accurate and current clinical information to insurance representatives.
• Follow up on requests for authorization for service on unpaid claims as requested by Patient Accounts staff.
• Maintain a strong working knowledge of precertification and referral requirements by insurance carrier.
• Perform any other related duties as directed by the immediate supervisor

• High School diploma or equivalent
• Minimum of two (2) years’ experience in the role of Precertification and Benefit/Insurance Verification Specialist, Intake Representative, Insurance Representative, or Prior Authorization Representative or related field in a hospital setting.
• Proficient in computers and relevant software applications.
• Ability to be proactive and take initiative.
• Possession of strong organizational skills.
• Excellent verbal and written communications.
• Ability to work independently on assigned tasks, as well as to accept direction on given assignments.
• Deals with confidential information and/or issues using discretion and judgement

Pay Transparency

To encourage pay transparency, promote pay equity, and proactively address regulations, UHS and all our subsidiaries will comply with all applicable state or local laws or regulations which require employers to provide wage or salary range information to job applicants and employees. A posted salary range applies to the current job posting. Salary offers may be based on key factors such as education and related experience.