Insurance Verification Representative - UHealth SoL Mia
Insurance Verification Representative - UHealth SoL Mia
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Job Description
Current Employees:
If you are a current Staff Faculty or Temporary employee at the University of Miami please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet please review this tip sheet.
The University of Miami UHealth at SoL Mia opening September 2025 will bring highquality academic medicine to North Miami Aventura and surrounding communities.
Our expert team of physicians and staff will represent a wide range of specialties including NCIdesignated Sylvester Comprehensive Cancer Center and Bascom Palmer Eye Institute the number one eye hospital in the nation. UHealth at SoL Mia will also deliver the latest in urologic treatments from the renowned Desai Sethi Urology Institute as well as topnotch care from UHealths nationally ranked neurology and neurosurgery programs.
The University of Miami/UHealth Central Business Office UHealth SoLMia has an exciting opportunity for a fulltime Insurance Verification Representative to work remotely.
CORE JOB SUMMARY
The individual in this position is part of theCentral Insurance Verification (CIV) department and will beresponsible for supporting functions that assist in creating and driving a culture of empathy serviceexcellence and delivery of patient centered care that impacts the patient experience across the UHealthSystem. Our Department thrives on teamwork and collaboration and we know our employees achieve thegreatest results when they are working together for a common goalto provide care for our patients. If youenjoy working in a collaborative environment then we have a job for you! Thispositionisresponsible for theverification of insurance eligibility benefits andobtainingauthorization forall insurance carriersfor all outpatient office visits and procedures scheduled within the UHealth person in this position must project a positive image of theorganization and positiondirectly impacts patient care patient satisfaction and the revenue cycle. This individual reports directly to theInsurance VerificationSupervisor.
CORE RESPONSIBILITIES
Accounts are completed in a timely manner in support of patient satisfaction and allow for referral and authorization activities prior to the patients date of service
Verification of eligibility and benefits via RTE in UChart online insurance websites telephone or other source of automated services
Add and/or edit insurance information in UChart such as validating that the correct guarantor account and plan listed in patients account with accurate subscriber information policy number and claims address and plan order.
Completes the checklist and document copay.
Creates referral if applicable Benefit only or Preauthorization and documents benefits information: deductible coinsurance and out of pocket benefits
Meets productivity standards for assigned work queue QA goal of 95 or greater and maintains WQ current at 14 days out with minimum daily pending visits
Assists in educating and acts as a resource to patients primary care and specialty care practices within the UHealth system and externally
Contact Primary Care Physician offices and/or Health Plans to obtain authorization or referral for scheduled services according to authorization guidelines listed in UHealth Contract Summary. Submits all necessary documentation required to process authorization request 2
Obtains authorization for both facility and provider for POS 22 and POS 19 clinics and provider only for POS 11 clinic locations
Enters and attaches authorization information in referral section of UChart
Communicates with patients and/or departments regarding authorization denial and/or redirection of patients by health plan or PCP office
Contact the Departments and/or patient when additional information is required of them or to alert regarding pending authorization status
Participates in process improvement initiatives 15 Customer Service
Provides customer service and assists patients and other UHealth staff with insurance related questions according to departmental standards
Ensures that patients are aware of issues regarding their financial clearance and educated on thereferral/authorizationprocess
Collaborates with Department and Patient Access teams to ensure that timely and concise communication occurs.
Ensures service recoveries and escalations are implemented with the guidance of their supervisors and according to departmental standards and guidelines
Performs other duties as assigned
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
Computer literate (EPIC scheduling and registration application experience a plus).
Strong written and oral communication skills.
Able to work in a team environment.
Graceful under pressure and stressful situations
Demonstrated knowledge of insurance includingauthorization/referralguidelines and requirements
Demonstrated ability to communicate effectively in written and verbal form. Bilingual knowledge a plus
Demonstrated ability to communicate effectively with physicians customers teammates and other staff
Ability to interact and assist patients of all ages cultural backgrounds and with special needs with a passion for providing excellent service and care
Ability to work under a high level of stress with time constraints while maintaining composure and sensitivity to each patients specific needs
Maintain a high level of diplomacy when dealing with stressful situations Is innovative proactive and resourceful in problem solving.
Any appropriate combination of relevant education experience and/or certifications may be considered.
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
