We’ve learned that what is best for patients is also best for employees. Learn more about why we are one of the Best Companies to Work for in Texas®. Job Summary Patient Authorization Representative is responsible for verifying insurance eligibility and ensuring all authorizations for pre certifications, inpatient and out- patient exams/ test are received. Reports to: Manager, assigned department Job Specific Responsibilities Daily assignments may include but are not limited to: • Verify insurance eligibility and benefits • Obtain and update patient benefits, identifying limitations and/or exclusions for each particular plan as it pertains to the patient’s care • Coordinate physician and/or facility referrals and pre certifications for patient appointments • Perform office administrative duties such as scheduling, processing POs/invoices, scanning, faxing, answering and routing phone calls, etc.. • Communicate with other hospital departments, insurance companies, and at times, patient’s family members to ensure continuity of care for reoccurring appointments, financial responsibility, and to ensure facility receives maximum reimbursement for services provided • Collect payments, establish payment arrangements, discuss payment options • Inpatient, Observation and Surgical management of authorization/ referrals and clinical processes. • Submit timely authorization and referrals using CPT, diagnosis and procedure codes. • Submit authorization on IPSNF, IPREHAB and IPLTC to ensure expedited patient discharges. • All other related assigned duties **Cancer Center Patient Authorization Representatives work with Financial Aid Office for screening determination of patient’s ability to pay Education and Experience • High School Diploma or GED • +3 years of experience working with insurance verifications and pre certifications, preferably in a hospital setting • +3 years use of medical terminology and preferred knowledge CPT codes, procedure codes and DRG’s classifications. Required Licensures/Certifications/Registrations N/A Skills and Abilities • Excellent customer service skills; Must speak, read, and write English fluently • Ability to multi- task, handle problems, interruptions, and other stressful situations in a professional manner. • Demonstrate planning, organizational and ability to follow-through until a process is complete. Interaction with Other Departments and Other Relationships Interacts with patients, family members, and other hospital departments Physical Capabilities Work involves sitting most of the time, but frequently involves walking or standing for brief periods of time. This position requires constant phone use. Talking and hearing is essential for communicating with physicians, coworkers, patients, insurance carriers, etc… Environmental/Working Conditions This position is subject to indoor and outdoor environmental changes that may include varying temperatures. UMC Health System provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment on the basis of race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. *Request for accommodations in the hire process should be directed to UMC Human Resources.* Benefits: Resilience program Emotional Physical Spiritual Financial Career Community On-Site Professional Counselors (EAP) Discounted Pharmacy Cost Cash Retention Bonus (only one in our region) Retirement Benefits w/Employer Match PTO & Extended Illness Medical, Dental, & Vision Insurance And more at: https://apps.umchealthsystem.com/documents/wellness.pdf UMC Vision, Mission and Standards: Vision: To Serve Our Patients in the Best Teaching Hospital in the Country Mission Statement: Service is our passion. We serve by providing safe, high quality care to all, achieving excellent financial performance, and training tomorrow’s healthcare professionals. Standards of Excellence: Attitude, Communication, Responsiveness, Compassion, Teamwork, Ownership, Safety and Respect About UMC Magnet Designated 501 licensed beds 62 Site locations Regions only Level I Trauma Center Regions only BICU DNV accredited Primary teaching hospital for the Texas Tech University Health Sciences Center (TTUHSC) Ranked as one of the Best Places to Work in Texas by Texas Monthly UMC Physicians Culture, Vision, Mission, and Standards: Culture: Service is Our Passion Vision: The best place to work and the best place to receive healthcare. Mission Statement: To improve the quality of life for our community by providing the best patient experience for every patient. Standards: Teamwork, Respect, Accountability, Compassion, Kindness About UMCP 35 Practice Locations – private practices and urgent care centers Over 125 physicians and advanced practice providers Ranked as “One of the Best Places to Work in Texas” by Texas Monthly Employee Engagement Score of 96% measured by Press Ganey Associates