Why UnityPoint Health? 

Commitment to our Team – We’re proud to be recognized as a Top 150 Place to Work in Healthcare by Becker's Healthcare several years in a row 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 an 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. 

• Caring is what we do, and it starts with our team members: expect paid time off, parental leave, 401K matching and an employee recognition program as we support you both personally and professionally. 
• You can only give your best when you feel your best, and we help you live well with dental and health insurance, paid holidays, short and long-term disability and more. We even offer pet insurance for your four-legged family members to give you peace of mind. 
• We strive to make things easier and more personal in health care to set us apart from the rest, and you can experience that commitment through early access to earned wages with Daily Pay, a tuition reimbursement program designed to help you further your career and adoption assistance to help you grow your family in the way that works for you. 

Diversity, Equity and Inclusion Commitment – At UnityPoint Health, we honor the ways people are unique and embrace what brings us together. Our collective goal is to champion a culture of belonging where everyone feels valued and respected.  

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. 

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

What are team member vaccine requirements?  

As part of keeping our communities safe and healthy, all team members must be vaccinated for influenza and Tdap, provide proof of immunity to MMR and varicella, and be tested for tuberculosis.  New hires must submit proof of vaccination or an approved exemption to begin work. If you have questions, please contact a recruiter or ask at any time during the interview process. UPH strongly recommends that all team members receive the updated COVID-19 vaccine, and at this time, UnityPoint Health – Meriter requires Covid-19 vaccination or an approved exemption. 

Location: Remote - Applicants preferrably live within the UnityPoint geography of Iowa, Illinois, or Wisconisn. 

Hours: Monday-Friday 8am-4:30pm 

We are looking for a Preauthorization Specialist to join our team! In this role, applicants can expect to obtain insurance eligibility, benefits, authorizations, pre-certifications and referrals for inpatient and outpatient, scheduled and non-scheduled visits. Applicants would update  demographic and insurance information in system as needed, and complete primary documentation for access and billing staff. Additionally applicants will resolve accounts on work queues, work with insurance companies to appeal denials, and interact in a customer-focused and compassionate manner to ensure patients and their representatives needs are met.

Insurance Verification/Certification 

• Obtains daily work from multiple work queues to identify what is required by CBO.
• 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
• Notify 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.
• Works with insurance companies, providers, coders and case management to appeal denied claims.

Customer Service 

• Adheres to department customer service standards.
• Perform research to resolve customer problems
• Collaborate with other departments to assist in obtaining pre-authorizations in a cross functional manner
• Develop and implement prior authorization workflow to meet the needs of the customers.
• Readily identifies work that needs to be performed and completes it without needing to be told.
• Coordinates work to achieve maximum productivity and efficiencies
• Monitors and responds timely to all inquiries and communications.

• Requires High school diploma or GED
• Previous customer service experience. · Experience interacting with patients and a working knowledge of third party payers.
• Two years of experience in a hospital patient access/patient accounts department, medical office/clinic or insurance company is desired.