Insurance Authorization Specialist-17001928 Care Site Description SCL Health is a faith-based, nonprofit health care organization headquartered in Broomfield with facilities located in Colorado, Kansas and Montana. SCL Health operates: 9 hospitals 4 safety net clinics 1 children's mental health treatment center 190+ ambulatory service centers Interested in making a difference? Then check us out. Our rich heritage and mission, and our focus on health care delivery that values person-centered care, excellence and accountability are a winning combination as we bring health—and hope—to our patients. Our ministry is dedicated to improving the health of the communities and individuals we serve, especially those who are poor and vulnerable. Visit www.sclhealthsystem.org Description This position is responsible for financial clearance of the patient account which includes initiating insurance verification, notification, pre-certification, authorization and obtaining reference numbers (as appropriate) for all Inpatient, Observation and Outpatient Services. Counsels the patient regarding their financial obligation, insurance benefits and appropriately communicate the patient liability. Acts as a liaison for the patient, physician office, care management team, community agencies and the Revenue Service Center. Verifies the ordering clinician credentials for add on outpatient encounters if not verified by the scheduling department at the time of scheduling. Works daily reports to ensure all payer specific billing requirements and authorization requirements are met. Obtains and verifies necessary demographic and billing information and updates that information in the eSummit system. Collects amounts owed for medical services including contacting the patient to secure payment. Assists with the follow up on appeals, denials, answer inquiries and update accounts as necessary. Identifies problems and communicates with the Revenue Service Center, Care Management team, Payer Relations and insurance companies in a timely manner. Remains flexible in scheduling to meet department and organizational needs to accommodate the scheduling process. Responsible for meeting productivity and quality measures. This is a PRN/Contingent position located in Broomfield, CO. Qualifications Minimum RequiredPreferred (Optional) EducationHigh School Diploma or Equivalent Additional Detail ExperienceMore than 1 year and less than 3 yearsMore than 3 years and less than 5 years Additional DetailTwo or more years in a hospital medical office or insurance experience. Three or more years collection experience Licensure, Certification or Registration CHAA (Certified Health Access Associate) Other: Knowledge, Skills and AbilitiesKnowledge of state Medicaid/Medicare programs Knowledge of payment assistance/charity programs Knowledge of payer requirements for authorization and billing Knowledge of ICD-9, ICD-10 and CPT coding Effective interpersonal and communication skills, including written, verbal and email etiquette. Proven customer service/problem solving skills. Proficient computer skills with MS Office products, including Outlook, Word and Excel. Knowledge of HIPAA regulations General knowledge of hospital billing preferred Medical Terminology preferred Other combinations of formal education, training and experience may be considered. Organization: Corporate, Various Locations Primary Location: CO-Denver/Boulder/Surrounding Areas-Broomfield Department: SYS-RSC Pre Access Schedule: Per Diem/PRN Shift: Day Shift Job Posting: Mar 10, 2017, 8:37:56 PM FTE: 0.01 Accounting and Finance
We reveal and foster God's healing love by improving the health of the people and communities we serve, especially those who are poor and vulnerable.
Inspired by our faith,
•We will be distinguished as the premier person-centered health system and trusted partner.
•We will share accountability with clinicians and other stakeholders to coordinate care across all settin...gs and improve access, quality, health outcomes, and affordability.
•We will grow as community-based health networks to serve more people in partnerships with others who share our vision and values.
Caring Spirit - We honor the sacred dignity of each person.
Excellence - We set and surpass high standards.
Good Humor - We create joyful and welcoming environments.
Integrity - We do the right thing with openness and pride.
Safety - We deliver care that seeks to eliminate all harm for patients and associates.
Stewardship - We are accountable for the resources entrusted to us.