Patient Access Representative

Uconn Health Center Farmington , CT 06030

Posted 1 week ago

Excellence, Teamwork, Leadership and Innovation. These are the values that define UConn Health, and we are looking for team members that share these same values. Our top rated organization is looking to add a full-time Patient Access Representative to our growing team. If you have a background in this field, we want to hear from you.

At UConn Health, this class is accountable for performing a full range of tasks in obtaining insurance referrals from physician's offices and insurance companies, and initiating follow-up on required pre-certifications for scheduled admissions and procedures in coordination with those offices.

SUPERVISIION RECEIVEFD:

Works unde the general supervision oif an employee ofa higher grade.

SUPERVISION EXCERCISED:

May lead/supervise lower level employees as assigned.

COMPREHENSIVE BENEFITS OFFERED:

  • Industry-leadinghealth insurance options and affordability

  • Generous vacation and sick-time plans

  • Multi-channel retirement options (pension and match options)

  • Tuition waiver and reimbursement for employees and qualified family members

  • Quick commute accessfrom I-84, Rte 9 and surrounding areas

  • State of the art facility and campus environments

  • Progressive leadership and educational development programs available

SCHEDULE: 40 hrs per wk, 8:30 a.m.

  • 5:00 p.m., Monday

  • Friday, 30 minute unpaid meal break

EXAMPLES OF DUTIES:

  • Identifies visits/procedures requiring prior approval

  • Utilizing knowledge of ICD-10, CPT coding and medical terminology, obtains required referral/prior authorization from insurance companies prior to date of service

  • Communicates with physician and medical providers regarding clinical clarifications to facilitate requests

  • Interviews patient via visits or phone to determine payment sources and payment arrangements

  • Verifies patient's benefits with insurance companies as needed

  • Refers uninsured and underinsured patients to financial counselors as identified

  • Assists in the appeals process for denied claims

  • Documents daily activities in the computer system

  • Communicates with departments regarding authorization status

  • Researches requests for patient information and prepares reports and correspondence

  • Maintains records and files may perform receptionist/triage duties

  • Performs related duties as required

MINIMUM QUALIFICATIONS REQUIRED

KNOWLEDGE, SKILLS, ABILITY:

  • Working knowledge of a managed care environment, third party reimbursement, hospital and community services and hospital and health care policies

  • Basic knowledge of medical coding and medical terminology

  • Skill in articulating information in a clear and informative manner to patients, family members, insurers, staff and other relevant parties

  • Organizational skills

  • Computer skills

  • Ability to gather and record all appropriate information that provides for the accurate billing and collection for provided services

  • Ability to interpret basic Medicare/Medicaid, and commercial insurance industry regulations

EXPERIENCE AND TRAINING:

Three (3) years of experience processing medical pre-authorizations and insurance verifications for healthcare services in a medical office or hospital setting.

SUBSTITUTIONS ALLOWED:

Associates degree and one (1) year of the experience as listed abovemay be substituted for the general experience.

PREFERRED REQUIREMENT:

  • Thorough knowledge of insurance benefits, workers compensation, coordination of benefits, and third party liability

  • Knowledge of medical terminology, and experience with ICD-10 and CPT coding

  • Experience with EPIC

  • Experience with electronic medical records

  • Experience in medical claim denials

FULL TIME EQUIVALENT MINIMUM SALARY: $48,797.00

Why UConn Health

UConn Health is a vibrant, integrated academic medical center that is entering an era of unprecedented growth in all three areas of its mission: academics, research, and clinical care. A commitment to human health and well-being has been of utmost importance to UConn Health since the founding of the University of Connecticut schools of Medicine and Dental Medicine in 1961. Based on a strong foundation of groundbreaking research, first-rate education, and quality clinical care, we have expanded our medical missions over the decades. In just over 50 years, UConn Health has evolved to encompass more research endeavors, to provide more ways to access our superior care, and to innovate both practical medicine and our methods of educating the practitioners of tomorrow.

All employees are subject to adherence to the State Code of Ethics which may be found at www.ethics.state.ct.us.

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