69 Insurance Specialist I Jobs in Dallas, TX
UT Southwestern Medical Center is Hiring an Insurance Specialist I Near Dallas, TX
Why UT Southwestern?
With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and research center, we strive to provide the best possible care, resources, and benefits for our valued employees. Ranked as the #1 hospital in Dallas-Fort Worth for the fifth consecutive year, we invite you to continue your healthcare career with us at William P. Clements Jr. University Hospital. You’ll discover a culture of teamwork, professionalism, and consistent opportunities for learning and advancement into leadership roles.
Summary
This position is responsible for obtaining information to initiate verification and precertification process.
Experience and Education
- High school and two (2) to four (4) years of benefit verification/authorization experience or equivalent.
Additional Information:
- Monitor and process insurance verification/eligibility
- Obtain PCP referrals for routine offices and surgical procedures efficiently
- Provide great customer service
- Maintain productivity metrics
- Ability to work in a fast-paced position
- Requires excellent time management skills
- Ability to multi-task
- Produce clear and concise documentation
- Strong understanding of insurance plans (PPOs, HMO, EPOs, Limited, and Exchanges)
- Shift: Monday-Friday 0730-1630 or 0800-1700 (40 hours)
- Work From Home (WFH), additional details related to this shall be discussed as part of the interview process
Functional ExperiencesFunctional - Customer Service/Customer service/1-3 Years
Functional - Clinical / Medical/Precertification/Predetermination/Authorizations/Verification/2-4 Years
Technologies Experiences
Technical - Desktop Tools/Microsoft Outlook/4-6 Years/End User
Technical - Desktop Tools/Microsoft Word/4-6 Years/End User
Technical – Office Equipment/Fax/Copier/4-6 Years/End User
Job Duties
- Monitors the correct patient work queue to determine accounts needing verification.
- Coordinates with physician\\'s office and/or ancillary department regarding additional information needed to obtain pre-certification and insurance benefits.
- Maintains department productivity standards.
- Pre-registers patient cases by entering complete and accurate information prior to patient\\'s arrival. Identifies and verifies all essential information pertaining to intake, insurance verification/eligibility, and precertification on all applicable patient accounts. Revises information in computer systems as needed
- Documents pertinent information and efforts in computer system based upon department documentation standards.
- Verifies insurance information by utilizing insurance websites or calling insurance companies to verify active coverage, deductible, copay and any other specific information needed in accordance to the verification guidelines.
- Create and call patients with cost estimate for scheduled appointments.
- Ensures all exams are scheduled with proper patient class and clinical indicators and coding nomenclature.
- Monitors, verifies, transcribes faxed documents to select insurance companies regarding authorization requests
- Accurately monitors, reviews, data enters and processes authorizations and validate that the requests are accurate, within the required timeline, and in compliance with the applicable insurance guidelines.
- Signs into and answers the assigned ACD line, documenting patient accounts per documentation expectations
- Follows strict quality measures of documents scanned into the electronic medical record and/or submitted to applicable insurance
- Protects the privacy and security of patient health information to ensure that confidentiality is maintained
- Counsels offices and/or patients when an out of network situation becomes apparent or other potential payor technicalities arise. Coordinates as needed with other departments/ancillary areas for special needs or resources.
- Pre-Registers patient cases by entering complete and accurate information in EPIC ADT hospital billing system prior to the patient's arrival. Identifies/obtains/verifies all essential information pertaining to intake, insurance verification/eligibility and pre-certification on all applicable patients accounts with a 95% accuracy rate. Accurately revises information in computer systems as needed. Documents pertinent information and efforts in computer system based upon department documentation standards.
- Demonstrates ongoing competency skills including above level problem solving skills and decision- making abilities.
- Maintains strictest confidentiality in accordance to policies and HIPAA guidelines.
- Enters accurately prior authorization data and in accordance with established guidelines, including diagnosis of service and procedure codes.
- Performs other related duties and projects as assigned. This job description should not be considered an exhaustive listing of all duties and responsibilities performed in this position. Our practice encourages all employees to develop personal and professional goals for themselves and will provide opportunities for continued growth and development.
Knowledge, Skills & Abilities
-
- Medicare/Medicaid/Government/Commercial Insurance Verification/Authorization
- Benefits Management/Interacting with Medical Professionals/ADVANCED
Effective and Efficient Problem Solving - Ability to read and write effectively
- Ability to interact with departmental management and communicate effectively in all patients and department interactions
Working Conditions
Work is performed primarily in general office area.
Security
This position is security-sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information
Salary
Salary Negotiable
UT Southwestern Medical Center is committed to an educational and working environment that provides equal opportunity to all members of the University community. As an equal opportunity employer, UT Southwestern prohibits unlawful discrimination, including discrimination on the basis of race, color, religion, national origin, sex, sexual orientation, gender identity, gender expression, age, disability, genetic information, citizenship status, or veteran status. To learn more, please visit:
Job Summary
Full Time
Ambulatory Healthcare Services
$46k-58k (estimate)
02/06/2023
07/01/2024
utsouthwestern.edu
DALLAS, TX
15,000 - 50,000
1943
BRUCE MICKEY
$1B - $3B
Ambulatory Healthcare Services
Related Companies
The job skills required for Insurance Specialist I include Initiative, Problem Solving, Customer Service, Collaboration, etc. Having related job skills and expertise will give you an advantage when applying to be an Insurance Specialist I. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Insurance Specialist I. Select any job title you are interested in and start to search job requirements.
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If you are interested in becoming an Insurance Specialist, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become an Insurance Specialist for your reference.
Step 1: Understand the job description and responsibilities of an Accountant.
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Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.
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