Patient Authorization Representative Lead

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

The Lead Patient Authorization Representative is responsible for verifying insurance schedules with staff 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:

• Facilitate training and ensuring updates to policies or procedures are communicated timely
• Coordinate insurance schedules with staff; Verify insurance eligibility and benefits
• Clear insurance retro denials
• Coordinate physician and/or facility referrals and pre certifications for patient appointments
• 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
• 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
• +5 years of experience working with insurance verifications and pre certifications, preferably in a hospital setting
• +2 years leadership experience, leading people and processes

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.*