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Insurance Authorization Specialist ID-14263

Welcome! We’re excited you’re considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you’ll find other important information about this position. This position is responsible for ensuring that the correct insurance and authorization information is recorded in the referral or auth/cert. Ensures services scheduled by both internal and outside providers have approved authorization as required by payer and procedure prior to service. Reaching out to internal clinics or outside physicians to obtain the required information if missing or incorrect. Escalates financial clearance risks as appropriate in compliance with the Financial Clearance Program. The verification of authorization information is needed for accurate billing and to ensure maximum reimbursement of services provided. 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Remote Data Entry, No Experience, $40/hr, Part-Time Remote Moderator, $40/hr, Weekend, No Degree, Part-Time Customer Support, $50/hr, Remote, Evening/Night Job, No Degree Remote Data Entry, $40/hr, Part-Time, College Student Job Remote Data Entry, $50/hr, No Experience, Evening/Night Job Phone Support, Remote, $35/hr, No Experience, Night Shift Remote Moderator, $35/hr, No Degree, Weekend, Part-Time Phone Support, $50/hr, Weekend, Remote, No Experience Virtual Assistant, $40/hr, No Experience, Remote, Night Job Phone Job, $45/hr, Remote, Night Shift, No Degree Virtual Assistant, $35/hr, Evening, Remote, College Student Phone Support, Remote, $35/hr, No Experience, Night Shift Remote Phone Job, $40/hr, Night Shift, College Student Friendly Virtual Assistant, No Experience, $40/hr, Remote, Part-Time Remote Phone Job, $40/hr, Night Shift, College Student Friendly Remote Customer Support, $40/hr, Night Job, No Experience Remote Phone Support, $40/hr, Evening, No Experience Required Data Entry, $40/hr, Part-Time, Remote, Weekend Job Live Chat Support, $40/hr, Weekend, Remote, College Student Remote Data Entry, $40/hr, Part-Time, No Degree Required Entry-Level Remote Data Entry, $50/hr, Evening Job Entry-Level Remote Data Entry, $35/hr, Evening Job Virtual Assistant, $40/hr, Weekend, College Student, Remote Virtual Assistant, No Degree, $40/hr, Remote, Part-Time Phone Support, Remote, $50/hr, No Experience, Night Shift Remote Data Entry, $40/hr, Evening/Night Job, No Experience Data Entry, No Experience, $50/hr, Remote, College Student Customer Support, $42/hr, Remote, Evening, No Experience Remote Data Entry, $40/hr, No Degree, Weekend, Night Job Part-Time Data Entry, $45/hr, Remote, College Student Friendly Customer Support, $42/hr, Remote, Evening, No Experience Live Chat Support, $40/hr, Remote, Entry Level, Part-Time Weekend Data Entry, $45/hr, Remote, No Experience Virtual Assistant, $50/hr, Weekend, No Degree, Remote Customer Support, $40/hr, Remote, Evening, No Experience Entry Level Phone Job, $40/hr, Remote, No Degree Required Remote Customer Support, $40/hr, Part-Time, College Student Virtual Assistant, $50/hr, Weekend, No Degree, Remote MINIMUM QUALIFICATIONS: EDUCATION AND EXPERIENCE 1. High School diploma or equivalent. PREFERRED QUALIFICATIONS: EDUCATION AND EXPERIENCE 1. 1 - 2 years’ experience working in a medical environment (such as a hospital, doctor's office, or ambulatory clinic). 2. Understanding of authorization processes, insurance guidelines, and third-party payors practices. 3. Must be proficient in Microsoft Office applications. Excellent communication and interpersonal skills. 4. Ability to prioritize and multitask a large work volume with high level of efficiency and attention to detail. CORE DUTIES AND RESPONSIBILITIES: As an advocate for WVUH/UHA employees, company and departmental goals and initiatives and HR Compliance, demonstrate knowledge of management and employee needs and apply that knowledge to create solutions. 1. Identifies all patients requiring pre-certification or pre-authorization at the time services are requested or when notified by another hospital or clinic department. 2. Contacts insurance company or employer to determine eligibility and benefits for requested services. 3. Use work queues within the EPIC system for maintaining authorization for referrals and surgeries. 4. Ensures accurate coding of the diagnosis, procedure, and facility align with authorization obtained. 5. Provides authorization verification of services timely to avoid unnecessary delays in treatment and reduce excessive nonclinical administrative time required of providers. 6. Utilize payor resources and any other applicable reference material to verify accurate prior authorization 7. Notifies scheduling and physicians of any cases not authorized. 8. Excellent time management and organization with time sensitive work. 9. Maintains compliance with departmental quality standards and productivity measures. 10. Works collaboratively and politely with internal and external contacts specifically Physicians, Financial Clearance/Counselor, Schedulers, and Nurses. 11. Uses hospital communications systems (fax, pagers, telephones, copiers, scanners, and computers) in accordance with hospital standards. 12. Maintain in baskets in Epic and emails in Outlook. 13. Participate in monthly team meetings and one-on-ones. 14. Follows established workflows, identifies deviations or deficiencies in standards/systems/processes and communicates problems to supervisor or manager. 15. Maintains confidentiality according to policy when interacting with patients, physicians, families, co-workers, and the public regarding demographic/clinical/financial information. SKILLS AND ABILITIES: 1. Excellent oral and written communication skills. 2. Practical knowledge of medical terminology. 3. Practical knowledge of ICD-10 and CPT coding. 4. Practical knowledge of third-party payors. 5. General knowledge of time-of-service collection procedures. 6. Excellent customer service and telephone etiquette. 7. Minimum typing speed of 25 words per minute. 8. Excellent reading and comprehension ability. Additional Job Description: Scheduled Weekly Hours: 40 Shift: Exempt/Non-Exempt: United States of America (Non-Exempt) Company: SYSTEM West Virginia University Health System Cost Center: 536 SYSTEM Hospital Authorization Unit Thank you for your interest in working for WVUM. Please explore our open opportunities in the list below and apply for any positions in which you would like to be considered. You'll be able to keep track of your progress on our site. The West Virginia University Health System, West Virginia's largest health system with more than 2,700 beds is the state��s largest private employer, is comprised of more than 20 hospitals, including a children's hospital and five institutes, all anchored by a 700-bed academic medical center in Morgantown, West Virginia. Learn more about WVU Medicine here: https://wvumedicine.org/about/
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