Patient Access Insurance Authorization Representative

14-Dec-2017, The Hospital - Other
Job Status: Full-Time   Location: Pittsburgh, PA

Job Summary

The Patient Access Authorization Representative will serve as an integral part of the team by providing customer service on behalf of The Children’s Institute’s Patient Access and Financial Services area. Responsible for interacting with physician offices and payors to resolve referral/authorization issues for outpatient services delivered at all sites. Communicates with families regarding service recommendations and benefit limitations.

Job Relationships

Responsible To: Patient Access Supervisor

Workers Supervised: None

Qualifications

Education: High School Diploma or GED. Prior experience in an office or health care setting preferred.

Licensure: N/A

Certification: N/A

Clearances: Act 73 FBI, Act 34 Criminal Clearance, Act 33 Child Clearance

**Clearances must be obtained within 30 days of hire in order to continue active employment.

Training and Experience: •Minimum 2 years experience in a customer service environment required
•Excellent telephone and interpersonal skills required.
•Knowledge of health plans preferred.
•Accurate typing and data entry skills.
•Experience with problem-solving and conflict resolution.
•Experience working under deadlines and handling multiple projects/assignments concurrently.
•Previous experience with computer technologies/software programs such as Microsoft Office, Windows, billing or scheduling software, etc. required.

Job Responsibilities

•Processes outpatient intakes and pre admits outpatients and inpatients in Hospital Information System with accuracy.
•Processes inpatient and outpatient admissions: obtains appropriate documentation, obtains signature on consent forms, confirms information previously gathered for inpatients and Squirrel Hill outpatients.
•Requests, obtains and appeals to physicians and insurance companies for prescriptions and authorizations/referrals for initial evaluation and ongoing treatment for outpatient services delivered at all sites.
•Interacts with therapists and families with regard to insurance benefits and service options.
•Processes changes in information pertaining to demographic and insurance information and communicates to appropriate staff.
•Orients all patients/families to The Children's Institute, educating them on all applicable processes and procedures including the Financial Assistance Policy.
•Scans appropriate documentation into Hospital Information System.
•Uses UM Module and/or PA notes as communication tool for all activity.

Employment Application

Employment Application Employment Application (201 KB)

Submit cover letter, resume, application and salary requirements

Lisa Wakefield
[email protected]
The Children's Institute of Pittsburgh
1405 Shady Avenue
Pittsburgh, PA 15217
Fax: 412-420-2299

No phone calls, please. Resumes and cover letters will only be accepted in PDF format if sent via email. You may also fax them to the number above. The Children's Institute of Pittsburgh is an Equal Opportunity Employer.

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