Job Details

Insurance Authorization Verification Specialist

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.

The Insurance Authorization Verification Specialist working in our Ob/Gyn Front End Revenue Cycle verifies insurance policy benefit information and obtains Authorization/Precertification, prior to the patient's visit or scheduled admission, or immediately following admission. Assist in identifying problems and ensures that the insurance is accurate on the patient account. Assures insurance information and appropriate referrals have been completely and accurately obtained. This will be a remote position following in-person training.

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:

Verifies insurance policy benefit information and obtains Authorization/Precertification, prior to the patient's visit or scheduled admission, or immediately following admission. Assist in identifying 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:

1. Verifies insurance policy benefits for new and returning patients with carriers and employers.
2. 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.
3. Identifies special policy clauses or pre-existing conditions and verifies effective date of policies.
4. Educates patients and families on insurance issues. Communicates patient's fiscal responsibility in a professional manner.
5. Notifies appropriate work units of patient's insurance coverage, authorizations, or status.
6. Identifies all patients without third party financial benefits and directs them for financial counseling according to Financial Counseling and Revenue Cycle policies and procedures.
7. Receives and reviews UT-H Health Science Center' Managed Care contracts to understand the contract provisions. Interprets managed care contracts for insurance coverage.
8. Provides support to Revenue Cycle work units and other work units as assigned.
9. Other duties as assigned.

Certification/Skills:

Minimum Education:

High school diploma or equivalent required; some college preferred.

Minimum Experience:

6 months of related experience required.

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 position is a security-sensitive position pursuant to Texas Education Code §51.215 and Texas Government Code §411.094. To the extent that a position requires the holder to research, work on, or have access to critical infrastructure as defined in Texas Business and Commerce Code §117.001(2), the ability to maintain the security or integrity of the infrastructure is a minimum qualification to be hired for and to continue to be employed in that position. Personnel in such positions, and similarly situated state contractors, will be routinely reviewed to determine whether things such as criminal history or continuous connections to the government or political apparatus of a foreign adversary might prevent the applicant, employee, or contractor from being able to maintain the security or integrity of the infrastructure. A foreign adversary is a nation listed in 15 C.F.R. §791.4.

Residency Requirement:

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