Insurance Verification Specialist UC San Diego UC San Diego 1,194 reviews

The Insurance Verification Specialist will collect insurance information from patients and enter in EPIC. Call insurance to verify benefits and calculate and document estimated patient benefits/patient financial responsibility. The Insurance Verification Specialist will discuss and explain patient benefits with patient/family. The Specialist meets with patient/family to sign financial documents. Create and track ongoing insurance authorizations. Work with clinicians and insurance companies to problem solve authorization discrepancies and errors. Work with clinicians and insurance companies to problem solve claims denials.

Work with clinicians and office administrative staff to accurately track patient attendance and service/level-of-care, and accurately report that data to insurance companies and billing/revenue managers. Register patients in EPIC, schedule patients in EPIC, check-in patients in EPIC. Open and close episodes of care in EPIC. Enter insurance authorization in EPIC and monitor authorizations. Collecting and recording patient notes from clinicians. Monthly analysis of open/close episodes. Training for clinicians regarding certain insurance processes. Analyzing rates of claims denials for various insurance providers. Analyzing length of stays and running certain types of reports.

MINIMUM QUALIFICATIONS

  • Six years of related experience, education/training, OR a Bachelor’s degree in related area plus two years of related experience/training
  • Experience and proven success in working knowledge of common organization-specific and other computer application programs.

SPECIAL CONDITIONS

  • Must be able to work various hours and locations based on business needs.
  • Employment is subject to a criminal background check and pre-employment physical.
  • Must be able to work various hours, days, shifts, on-call and various locations based on the 24-hour Medical Center's business needs.

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