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UT Health Insurance Authorization Verification Specialist II in Texas Medical Center-Houston, Texas

Insurance Authorization Verification Specialist II

Texas Medical Center-Houston, Texas

Professional/Managerial

McGovern Medical School at UTHealth

Requisition #: 210002O0

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:

Three years 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 job class may contain positions that are security sensitive and thereby subject to the provisions of Texas Education Code § 51.215

If you are looking for a great healthcare career in Houston, visithttp://go.uth.edu/careers!

University of Texas Health Science Center at Houston (UTHealth)

Established in 1972 by The University of Texas System Board of Regents, The University of Texas Health Science Center at Houston (UTHealth) is Houston’s Health University and Texas’ resource for health care education, innovation, scientific discovery and excellence in patient care. The most comprehensive academic health center in the UT System and the U.S. Gulf Coast region, UTHealth is home to schools of biomedical informatics, biomedical sciences, dentistry, nursing and public health and the John P. and Kathrine G. McGovern Medical School. UTHealth includes The University of Texas Harris County Psychiatric Center, as well as the growing clinical practices UT Physicians, UT Dentists and UT Health Services. The university’s primary teaching hospitals are Memorial Hermann-Texas Medical Center, Children’s Memorial Hermann Hospital and Harris Health Lyndon B. Johnson Hospital.

UTHealth Benefits

UTHealth offers a comprehensive and competitive benefits package. For more information on our benefits programs please refer to the UTHealth Office of Benefits Website.

https://www.uth.edu/benefits/benefits-summary.htm

Equal Employment Opportunity Statement

UTHealth is committed to providing equal opportunity in all employment-related activities without regard to race, color, religion, sex, sexual orientation, national origin, age, disability, genetic information, gender identity or expression, veteran status or any other basis prohibited by law or university policy. Reasonable accommodation, based on disability or religious observances, will be considered in accordance with applicable law and UTHealth policy. The University maintains affirmative action programs with respect to women, minorities, individuals with disabilities, and eligible veterans in accordance with applicable law.

COVID-19 Protocol

As you may already know, UTHealth recently decided to take an important and necessary step to protect members of our community against COVID-19 by making COVID-19 vaccinations mandatory for all employees, residents, fellows, contractors, and volunteers. Individuals subject to the vaccination requirement must be fully vaccinated on or by January 4th, 2022. Additionally, all members of our community—including students and visitors—are required to comply with our new COVID-19 Workplace Safety Protocol, which contains masking and physical distancing requirements that applies in certain settings depending on the individual’s vaccination status.

In addition, all UTHealth employees who are assigned to work at a location that is subject to the affiliated partner’s hospital, clinical offices, or agency are required to abide by UTHealth’s rules and regulations, as well as the affiliate’s rules and regulations, including COVID-19 vaccination requirements.

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