Admitting Officer I - Center for Women's Health

Position Summary:

Under direct supervision, performs basic insurance verification and pre-authorization for Women's Health services. This includes reviewing clinic schedules and obtaining pre-authorization from insurance carriers for specialist visits, clinic based procedures and courses of treatment.

Duties & Responsibilities:

• Insurance Preauthorization: Serves as a liaison between patients, healthcare providers, billing departments, and insurers.
• Contacts patients to explain healthcare benefits and healthcare facility policies.
• Manages authorizations for health procedures in an electronic health record (EHR) system which could include documenting communications with insurance providers, monitoring pre-authorization expirations, and requesting extensions.
• Reviews clinic schedules and procedure calendar for visits that require preauthorization. Identifies appropriate procedural and diagnostic coding (as needed) consultation with providers.
• Verifies insurance benefits, determines eligibility and estimates financial liability for outpatient services.
• Performs insurance pre-authorization for services; Documents authorization in electronic medical record.
• Develops pre-authorization tools / quick reference guides to identify procedures / payers that do not require pre authorization
• General Clinic Responsibilities: Participates in departmental / ambulatory / UI Health process improvement teams.
• Performs administrative duties such as answering phones, relaying calls and messages, providing information.
• Maintains current knowledge of all relevant insurance coding, contracts, guidelines, policies an, requirements by attending appropriate in-service training offered by Revenue Integrity Serves as resource for department for managed care coverage issues.
• Adds appointments to schedule for procedures and notifies patient of appointment.
• Performs other related duties and participates in special projects as assigned.