Job description

Overview

Preauthorization Specialist

Cardiovascular Center/Waterloo, IA

Remote*

PRN As Needed, Monday-Friday 8:00 - 5:00

Obtains insurance eligibility, benefits, authorizations, and pre-certifications for scheduled and non-scheduled visits and procedures performed at hospital. Updates demographic and insurance information in system as needed. Primary documentation source for access and billing staff. Resolve accounts on work queues. Interacts in a customer-focused and compassionate manner to ensure patients and their representatives needs are met. Assists in scheduling any non-invasive procedures and/or tests as directed.

Why UnityPoint Health? 

Commitment to our Team – We’ve been named a Top 150 Place to Work in Healthcare 2022 by Becker’s Healthcare for our commitment to our team members. 
Culture – At UnityPoint Health, you matter. Come for a fulfilling career and experience a culture guided by uncompromising values and unwavering belief in doing what's right for the people we serve. 
Benefits – Our competitive Total Rewards program offers benefits options that align with your needs and priorities, no matter what life stage you’re in. 
Diversity, Equity and Inclusion Commitment – We’re committed to ensuring you have a voice that is heard regardless of role, race, gender, religion, or sexual orientation. 
Development – We believe equipping you with support and development opportunities is an essential part of delivering a remarkable employment experience. 
Community Involvement – Be an essential part of our core purpose—to improve the health of the people and communities we serve.

 

Visit us at UnityPoint.org/careers to hear more from our team members about why UnityPoint Health is a great place to work. https://dayinthelife.unitypoint.org/  

Responsibilities

Work with providers to assure that CPT and ICD-10 code is correct for procedure ordered and is authorized when necessary.
Completes eligibility check and obtain benefits though electronic means or via phone contact with insurance carriers or other agencies and when necessary/requested provide initial clinical documentation.
Initiates pre-certification process with physicians, PHO sites or insurance companies and obtains pre-cert/authorization numbers and adds them to the electronic health record and other pertinent information that secures reimbursement of account.
Perform follow-up calls as needed until verification/pre-certification process is complete.
Thoroughly documents information and actions in all appropriate computer systems.
Notifies and inform Utilization Review staff of authorization information to insure timely concurrent review.
Validates or update insurance codes and priority for billing accuracy.
Works with insurance companies to obtain retroactive authorization when not obtained at time of service.

Qualifications

High School or Vocational School graduate.
Previous medical office experience preferred.
Previous experience with an electronic health record or medical office software preferred.
Previous experience coding diagnoses and procedures with ICD09-CM and CPT preferred.
Ability to demonstrate strong customer service skills.
Ability to effectively enter information into a variety of computer programs.
Ability to understand and apply guidelines, policies and procedures.
Ability to interact effectively with physicians, health care team members, individuals and members of their support systems.
Ability to communicate effectively with people of diverse professional, education and lifestyle backgrounds.
Writes, reads, comprehends and speaks fluent English.
Multicultural sensitivity.
Microsoft Office – basic computer skills.
Customer/patient focused.
Critical thinking skills using independent judgment in making decisions.
Knowledge of medical terminology, anatomy and physiology preferred.
Area of Interest: Patient Services;
FTE/Hours per pay period: 0.01;
Department: Cardiology- Donald Street;
Shift: PRN As Needed, Monday - Friday, Daytime;
Job ID: 157310;