Insurance Verification Representative - REMOTE

  • University of Miami Miller School of Medicine
  • Remote * (Miami, FL, USA)
  • Jan 15, 2022
Risk Management Telecommuting

Job Description

Current Employees:

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Transforming Lives

The University of Miami is among the top research universities and academic medical centers in the nation, and one of the largest private employers in South Florida.

With more than 16,000 faculty and staff, the University strives for excellence, and is driven by a powerful mission to transform and impact the lives of its students, patients, members of the community, and people across the globe.

The University is committed to fostering a culture of belonging, where everyone feels valued and has the opportunity to add value. Through values of Diversity, Integrity, Responsibility, Excellence, Compassion, Creativity, and Teamwork (DIRECCT) the U community works together to create an environment driven by purpose, excellence, community, and service.

The Central Business Office has an exciting opportunity for a Full-time Insurance Verification Representation to work based out of the Coral Gables Campus. The Insurance Verification Representative is responsible for the verification of insurance eligibility, benefits and obtaining authorization for all insurance carriers for all outpatient office visits and procedures scheduled within the UHealth Systems. The person in this position must project a positive image of the organization and department. This position directly impacts patient care, patient satisfaction and the revenue cycle. This individual reports directly to the Insurance Verification Supervisor.

* Accounts are completed in a timely manner in support of patient satisfaction and allow for referral and authorization activities prior to the patient's date of service.

* Verification of eligibility and benefits via RTE in UChart, online insurance websites, telephone or other source of automated services.

* Add and/or edit insurance information in UChart such as validating that the correct guarantor account and plan listed in patient's account with accurate subscriber information, policy number, and claims address and plan order.

* Meets productivity standards for assigned work queue, QA goal of 95% or greater and maintains WO current at 14 days out with minimum daily pending visits.

* Assists in educating and acts as a resource to primary care and specialty care practices within the UHealth system.

* Contacts Primary Care Physician offices and/or Health Plan to obtain authorization or referral for scheduled services according to authorization guideline listed in UHealth Contract Summary. Submits all necessary documentation required to process authorization request.

* Obtains authorization for both facility and provider for POS 22 clinics and provider only for POS 11 clinic locations.

* Enters and attaches authorization information in referral section of UChart.

* Communicates with patients and/or departments regarding authorization denial and/or re-direction of patient by health plan or PCP office.

* Contacts the Departments and/or patient when additional information is required of them or to alert regarding pending authorization status.

* Provides exemplary customer service and assist patients and other UHealth staff with insurance related questions.

This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities as necessary.


* High School Diploma or equivalent

* One Year of Experience is required

* Strong written and oral communication skills.

* Able to work in a team environment.

* Demonstrated knowledge of insurances

* Demonstrated ability to communicate effectively in written and verbal form. Bi-lingual knowledge a plus.

* Demonstrated ability to communicate effectively with physicians and professional staff.

* Ability to interact and assist patients of all ages, cultural background and with special needs, with a passion for providing excellent service and care.

* Ability to work under a high level of stress with time constraints while maintaining composure and sensitivity to each patient's specific needs.

Any appropriate combination of relevant education, experience and/or certifications may be considered.

The University of Miami offers competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more.

UHealth-University of Miami Health System, South Florida's only university-based health system, provides leading-edge patient care powered by the ground breaking research and medical education at the Miller School of Medicine. As an academic medical center, we are proud to serve South Florida, Latin America and the Caribbean. Our physicians represent more than 100 specialties and sub-specialties, and have more than one million patient encounters each year. Our tradition of excellence has earned worldwide recognition for outstanding teaching, research and patient care. We're the challenge you've been looking for.

Patient safety is a top priority. As a result, during the Influenza ("the flu") season (September through April), the University Of Miami Miller School Of Medicine requires all employees who provide ongoing services to patients, work in a location (all Hospitals and clinics) where patient care is provided, or work in patient care or clinical care areas, to have an annual influenza vaccination. Failure to meet this requirement will result in rescinding or termination of employment.

The University of Miami is an Equal Opportunity Employer - Females/Minorities/Protected Veterans/Individuals with Disabilities are encouraged to apply. Applicants and employees are protected from discrimination based on certain categories protected by Federal law. Click here for additional information.

Job Status:

Full time

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