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.
Works unde the general supervision oif an employee ofa higher grade.
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
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.
Associates degree and one (1) year of the experience as listed abovemay be substituted for the general experience.
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.
Uconn Health Center