Insurance Verification Representative H
Insurance Verification Representative H
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Job Description
Current Employees:
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The University of Miami Health System UHealth Department of PediatricsEarly Steps has an exciting opportunity for a FullTime Insurance Verification Representative to work in Miami.
The Insurance Verification Representative ensures that proper insurance authorizations are processed prior to patients appointments to ensure a smooth and efficient visit for the patients.
Core Responsibilities:
Calls insurance companies and patients to verify insurance information.
Obtains authorization for HMO patients.
Verifies claims are mailed to the proper address.
Contacts physicians insurance companies and/or necessary department(s) to obtain authorizations or referrals.
Contacts patient to obtain additional information when necessary.
Responds to customer inquiries regarding insurance coverage for services and processing of claims.
Adheres to University and unitlevel policies and procedures and safeguards University assets.
Department Specific Functions:
Communicates with various insurance companies to verify benefits.
Reviews and follows up on denials /Explanation of Benefits (EOBs) received.
Reviews patient charts including demographic patient/guarantor information procedures/charges and diagnosis codes to verify and extract payment info.
Obtains Medicaid/ HMO/MediPass authorizations and referrals information when necessary.
Posts Medicaid and other 3rd party payments in the CMS Database system as needed
Inputs Direct Services payments into the State database for Childrens Medical Services (CMS) as needed.
Communicates identified problems to Supervisor / Fiscal Manager and makes recommendations as appropriate.
Performs other jobrelated duties within job scope as requested by Fiscal Manager.
This list of duties and responsibilities is not intended to be allinclusive and may be expanded to include other duties or responsibilities as necessary.
CORE QUALIFICATIONS:
High School diploma or equivalent
Minimum 1 year of relevant work experience
Ability to maintain effective interpersonal relationships.
Skill in completing assignments accurately and with attention to detail.
Ability to process and handle confidential information with discretion.
Ability to work independently and/or in a collaborative environment.
Proficiency in computer software (i.e. Microsoft Office).
Ability to communicate effectively in both oral and written form.
Knowledgeable about different insurance companies and how to read an Explanation of Benefits (EOBs Skill in collecting organizing and analyzing data Skill in data entry with minimal errors.
Ability to work independently and/or in a collaborative environment.
Commitment to the Universitys core values.
Any relevant education certifications and/or work experience may be considered.
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The University of Miami offers competitive salaries and a comprehensive benefits package including medical dental tuition remission and more.
UHealthUniversity of Miami Health System South Floridas only universitybased health system provides leadingedge patient care powered by the ground breaking research and medical education at the Miller School of Medicine. As an academic medical center we are proud to serve South Florida Latin America and the Caribbean. Our physicians represent more than 100 specialties and subspecialties and have more than one million patient encounters each year. Our tradition of excellence has earned worldwide recognition for outstanding teaching research and patient care. Were the challenge youve been looking for.
The University of Miami is an Equal Opportunity Employer Females/Minorities/Protected Veterans/Individuals with Disabilities are encouraged to apply. Applicants and employees are protected from discrimination based on certain categories protected by Federal law. Click here for additional information.
Job Status:
Full timeEmployee Type:
StaffPay Grade:
H3Required Experience:
Unclear Seniority
Employment Type
Full-Time
