Ins Verify Rep III

Job description

JOB RESPONSIBILITIES: Pre-Authorization - Utilize systems including medical records to obtain needed clinical support to efficiently confirm receipt of or to obtain pre-authorization for scheduled services and medications that require a higher level of clinical knowledge. Collaborate with internal and external resources regarding specific authorizations scenarios and manages escalated issues and provides feedback to team members. Work with team to make contact with families prior to patient scheduled visits and/or services to confirm insurance eligibility, referrals/authorizations with minimal stress to the family/patient. Problem Resolution - Serve as second level problem resolution for both internal and external customers, involving Manager, if necessary. Responsible for research, analysis and resolution of complex issues and questions. Identify patterns in questions and problem issues with staff and participate in determining and addressing root causes. Collaboration - Serve as a liaison between Hospital/Physicians Billing Service, Admitting, Outpatient Surgery, Outpatient Department, Patient Financial Services, Utilization Review and other Cincinnati Children's departments. Mul...