Full-Time 40 hours/week, Benefitted
Responsible for verifying eligibility of benefits and obtaining insurance authorizations for all patients that receive care in the Physical Medicine and Rehabilitation outpatient departments. Works with provider’s offices on authorizations and denials as applicable. Supports the Scheduling/Financial Specialists when assistance is needed.
About UnityPoint Health - UnityPlace:
UnityPoint Health - UnityPlace is proud to offer the most comprehensive addiction and mental health services in the Peoria, Illinois region to you and your family. UnityPlace was formed by the joining of UnityPoint Health®, Human Service Center and Tazwood Center for Wellness in April of 2019. UnityPlace is a new non-profit organization dedicated to meeting the growing behavioral health care needs of the community. Our compassionate and committed treatment team is comprised of many experts from psychiatry and addiction medicine.
Our goal is to deliver comprehensive behavioral healthcare to optimize the patient's well-being. It is our privilege to partner with our patients on their journey of healing.
As a member of the UnityPlace Team, our team members are eligible for a benefits package including:
Additional benefits are available, apply today to discuss our full benefits package!
Why UnityPoint Health?
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.
· Establish effective rapport and work closely with clinical staff, doctor’s offices, patients and families to ensure that all patients have authorization for services performed.
· Contacts providers with authorizations and denials as applicable.
· Problem solves, analyzes and collaborates with patient, therapist, central billing office, revenue cycle department, and insurance companies to identify and resolve billing and denial issues, including sending appeals and trouble- shooting and correcting claim or account errors.
· Documents denials and billing issues to identify processes that need improvement in order to maximize efficiency and ensure proper payment within the department(s).
· Verifies eligibility and authorization needs of current and new patients for services.
· Performs telephone and on-line authorizations for our services.
· Initiates and coordinates prior authorization requests to third party payers and maintains a working knowledge of third-party payer guidelines. Follows up with third-party payers as necessary.
· Assist in gathering information from doctor’s offices and clinical staff to determine continued services.
· Assists in educating and acts as a resource to clinical and non-clinical staff.
· Accurately enters required information into EPIC.
· Performs billing audits as needed to ensure proper payment.
· Meet specified deadlines as required for continued patient care and patient satisfaction.
· Maintains a working knowledge of relevant regulations affecting patients and the operation of our business.
Basic UPH Performance Criteria
· Demonstrates the UnityPoint Health Values and Standards of Behaviors as well as adheres to policies and procedures and safety guidelines.
· Demonstrates ability to meet business needs of department with regular, reliable attendance.
· Employee maintains current licenses and/or certifications required for the position.
· Practices and reflects knowledge of HIPAA, TJC, DNV, OSHA and other federal/state regulatory agencies guiding healthcare.
· Completes all annual education and competency requirements within the calendar year.
· Is knowledgeable of hospital and department compliance requirements for federally funded healthcare programs (e.g. Medicare and Medicaid) regarding fraud, waste and abuse. Brings any questions or concerns regarding compliance to the immediate attention of hospital administrative staff. Takes appropriate action on concerns reported by department staff related to compliance.
Identify items that are minimally required to perform the essential functions of this position.
Preferred or Specialized
Not required to perform the essential functions of the position.
Associate or Bachelor’s Degree.
Previous customer service experience.
Knowledge of medical terminology.
Knowledge of medical billing and insurance.
Strong problem-solving skills.
Proficient in Microsoft office.
Demonstrate a professional image in dealing with the public, patients, families, payers and doctor’s offices.
Understanding of ICD (International Statistical Classification of Diseases and Related Health Problems) 10 Codes and Current Procedural Terminology (CPT) Coding.
Knowledge of EPIC.