Insurance Specialist

Job Summary:

The University of Colorado Anschutz Medical Campus has an opening for a full-time University Staff (unclassified) Insurance Specialist in the Department of Psychiatry. Clinics are located in Aurora Colorado at the School of Medicine. Programs in the various clinics include traditional psychiatric and psychological outpatient treatment; support and therapy groups, trauma care for adolescents and adults; Student Resident Mental Health; gender responsive services as well as specialty services for Women going through Cancer Therapy and Menopause.

This position will report to and serve under the supervision of the Supervisor and Business Services Manager at the Department of Psychiatry. This position is responsible for managing various patient registration, revenue cycle and administrative duties for any assigned clinics. While providing those duties, they should endeavor to provide excellent customer service, leaving a positive impression on patients, providers and staff. They will be expected to perform routine insurance reviews, prior authorization requests, obtain and verify patient demographics, train clinic PSRs in all aspects of registrations, provide routine insurance updates, train insurance staff, and act as the subject matter expert for their assigned area. Additionally, this individual will be responsible for troubleshooting patient billing issues in coordination with CU Medicine. They will primarily focus on their assigned area but will also be expected to provide coverage to other clinical areas, as needed.

Key Responsibilities:

• Evaluate and communicate patient’s potential financial liability directly to the patient prior to medical services being rendered based on insurance verification data and medical cost estimates.

• Obtain insurance authorization and pre-certification for behavioral health services, document covered and non-covered benefits, plan type, co-payments, co-insurance, out of pocket, and deductible amounts and determining contract and benefit eligibility. Contact insurance companies as needed.

• Review, process, and audit the medical necessity for each patient behavioral health treatment and documentation insurance authorization including review of CPT/ICD diagnosis codes.

• Work as a patient advocate and functions as a liaison between the patient and payer to answer reimbursement questions and avoid insurance delays.

• Communicate with patient access and medical staff to inform them of any restrictions or special requirements in accordance with insurance plans.

• Update coding/payer guidelines for clinical staff and adheres to CU Medicine guidelines with obtaining authorization.

• Track pathways and performs various other business office functions on an as needed basis.

• Identifies and refers problematic workflow trends to Supervisor for evaluation and solution.

Work Location:

Onsite – this role is expected to work onsite and is located in Aurora, CO, State.

Why Join Us:

The University of Colorado Anschutz Medical Campus is a world-class medical destination at the forefront of transformative science, medicine, education and patient care. The campus encompasses the University of Colorado health professional schools, more than 60 centers and institutes, and two nationally ranked independent hospitals - UCHealth University of Colorado Hospital and Children's Hospital Colorado - that treat more than two million adult and pediatric patients each year. Innovative, interconnected and highly collaborative, the University of Colorado Anschutz Medical Campus delivers life-changing treatments, patient care and professional training and conducts world-renowned research fueled by over $650 million in research grants. For more information, visit www.cuanschutz.edu.

The Department of Psychiatry is one of the largest units in the UCD-SOM and is comprised of 5 Divisions. The CU Department of Psychiatry sets the standard for Education and Training of leaders in psychiatry and mental health care, conducts ground-breaking Research that aims to eradicate suffering due to psychiatric and substance use disorders, provides ready access to state of-the-art mental health preventions and interventions across the continuum of care, and collaborates with the community and other key stakeholders to promote well-being among all Coloradans. We accomplish this vision in a manner that respects, values and advocates for the dignity and worth of each individual and family.

Why work for the University?

We have AMAZING benefits and offer exceptional amounts of holiday, vacation and sick leave! The University of Colorado offers an excellent benefits package including:

• Medical: Multiple plan options

• Dental: Multiple plan options

• Additional Insurance: Disability, Life, Vision

• Retirement 401(a) Plan: Employer contributes 10% of your gross pay

• Paid Time Off: Accruals over the year

• Vacation Days: 22/year (maximum accrual 352 hours)

• Sick Days: 15/year (unlimited maximum accrual)

• Holiday Days: 10/year

• Tuition Benefit: Employees have access to this benefit on all CU campuses

• ECO Pass: Reduced rate RTD Bus and light rail service

There are many additional perks & programs with the CU Advantage.

Qualifications:

Minimum Qualifications:

• 3 years of insurance verification, financial counseling, patient financial services, patient registration.

  • Substitution: A combination of related education and/or relevant experience in an occupation related to the work assigned equal to three (3) years.

Applicants must meet minimum qualifications at the time of hire.

Preferred Qualifications:

• A bachelor’s degree in biological science, nursing, health, human services, psychology, counseling, social work, or a directly related field from an accredited institution.

• Experience using Electronic Health Record and Patient Health Information management systems.

• Billing and coding experience.

• Experience with healthcare EMR (EPIC).

Conditions of Employment:

• Applicants must be legally authorized to work in the United States without requiring sponsorship. We are unable to provide work visa sponsorship or employment authorization for this position now or in the future.

Knowledge, Skills and Abilities:

• Ability to communicate effectively, both in writing and orally.

• Ability to establish and maintain effective working relationships with employees at all levels throughout the institution.

• Outstanding customer service skills.

• Knowledge and understanding of insurance authorizations, EMR, eligibility software, scheduling software, scanning, and vendor systems.

• Ability to use independent judgment.

• Ability to work with diverse patient population, providers, and staff.

• Ability to comply with established rules, policies and procedures and meet deadlines.