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Role Description

Verifies insurance policy benefit information and obtains Authorization/Precertification, prior to the patient’s visit or scheduled admission, or immediately following admission. Assist in identifying problems and ensures that the insurance is accurate on the patient account. Assures insurance information and appropriate referrals have been completely and accurately obtained.

Eligibility and Verifications to join our Revenue Cycle team. UTHealth is seeking a motivated Insurance Verification Specialist II to join our Revenue Cycle team. This role handles daily operations for assigned providers, including:

• Verifying insurance benefits
• Obtaining authorizations
• Ensuring accurate referrals

Specialists maintain productivity, meet UTHealth metrics, and resolve insurance issues while delivering excellent patient service. We’re looking for a team member who values efficiency, accuracy, and creating positive patient experiences.

Qualifications

• High school diploma or equivalent required; some college preferred.
• Three years of related experience required.

Requirements

• Verifies insurance policy benefits for new and returning patients with carriers and employers.
• Assures all insurance information has been completely and accurately obtained.
• Documents all pertinent insurance information.
• Identifies special policy clauses or pre-existing conditions and verifies effective date of policies.
• Educates patients and families on insurance issues.
• Communicates patient’s fiscal responsibility in a professional manner.
• Notifies appropriate work units of patient’s insurance coverage, authorizations, or status.
• Identifies all patients without third party financial benefits and directs them for financial counseling according to Financial Counseling and Revenue Cycle policies and procedures.
• Receives and reviews UT-H Health Science Center’s Managed Care contracts to understand the contract provisions.
• Interprets managed care contracts for insurance coverage.
• Provides support to Revenue Cycle work units and other work units as assigned.
• Other duties as assigned.

Benefits

• 100% paid medical premiums for our full-time employees.
• Generous time off (holidays, preventative leave day, both vacation and sick time – all of which equates to around 37-38 days per year).
• The longer you stay, the more vacation you’ll accrue!
• Longevity Pay (Monthly payments after two years of service).
• Awesome retirement/pension plan.
• Free financial and legal counseling.
• Free mental health counseling services.
• Gym membership discounts and access to wellness programs.
• Other employee discounts including entertainment, car rentals, cell phones, etc.
• Resources for child and elder care.
• Plus many more!

Company Description

UTHealth Houston is Texas’ resource for healthcare education, innovation, scientific discovery, and excellence in patient care.