Admitting Officer I - Patient Access

Position Summary:

The incumbent reports to the Assistant Director of Revenue Management, who reports to the Director of Revenue Management, Patient Access Services, who reports to the Associate CFO, who reports to Chief Financial Officer. Under direct supervision, performs basic insurance verification and pre-authorization for outpatient services. Assists to ensure services performed in clinic have met medical necessity guidelines of the insurance carrier and pre-authorization/referrals have been obtained per the payers requirements, maximizing reimbursement in the claim submission process.

Duties & Responsibilities:

• Contacts insurance providers to obtain any applicable authorization types prior to service.
• Obtains and / or coordinates with third-party payers authorizations for services.
• Monitors expirations of authorizations and initiates requests for extensions.
• Documents and updates all authorizations obtained in UI Health systems.
• Obtains and scans all appropriate documents, as applicable.
• Maintains applicable assigned work queues and expected lead times.
• Within UI Health work queues, documents and closes tasks upon completion.
• Updates work in progress on outstanding tasks.
• Maintains expected lead times and organization while completing tasks.
• Consistently performs and exceeds departmental minimum expected productivity goals.
• Ability to complete registration and coverage verification, as necessary.
• Determines if patient is eligible for intended care at UI Health.
• If necessary, contacts patient to obtain correct insurance information, or informs patient of UI Health self-pay policy.
• May perform patient estimates, as necessary.
• Updates all demographic / coverage / eligibility information in UI Health system.
• Provides excellent customer services to patients, providers, and clinic staff in person and via telephone.
• Completes interactions with respect and courtesy.
• Provides general information regarding UI Health when appropriate.
• Continues education on payers / payer requirements and UI Health contracts.
• Maintains technical knowledge of items necessary for financial clearance at UI Health for intended services.
• Stays up to date as policies and necessary documentation and payer requirements change.
• Maintains competence and technical knowledge.
• Maintains a working knowledge of necessary registration and eligibility systems.
• Perform other related duties and participate in special projects as assigned.