What are the responsibilities and job description for the Specialist I, Patient Access, Insurance Verification position at Denver Health?
We are recruiting for a motivated Specialist I, Patient Access, Insurance Verification to join our team!
We are here for life’s journey.
Where is your life journey taking you?
Being the heartbeat of Denver means our heart reflects something bigger than ourselves, something that connects us all:
Humanity in action, Triumph in hardship, Transformation in health.
Department
Admissions & Registration Scvs
Job Summary
Under minimal supervision, collects comprehensive demographic and insurance information required for facilitating timely and accurate billing of patients presenting for services. Verifies and identifies patient payer sources and obtains insurance authorizations for patients admitted to the hospital/emergency department or referred to ancillary /specialty services. Performs the appropriate notification of admission (NOA) to payers for their members who are admitted to Denver Health for ongoing treatment and services. Documents gathered patient authorization information.
Essential Functions
Knowledge, Skills and Abilities:
Days (United States of America)
Work Type
Regular
Salary
Benefits
Denver Health is an integrated, high-quality academic health care system considered a model for the nation that includes a Level I Trauma Center, a 555-bed acute care medical center, Denver’s 911 emergency medical response system, 10 family health centers, 19 school-based health centers, Rocky Mountain Poison & Drug Safety, a Public Health Institute, an HMO and The Denver Health Foundation.
As Colorado’s primary, and essential, safety-net institution, Denver Health is a mission-driven organization that has provided billions in uncompensated care for the uninsured. Denver Health is viewed as an Anchor Institution for the community, focusing on hiring and purchasing locally as applicable, serving as a pillar for community needs, and caring for more than 185,000 individuals and 67,000 children a year.
Located near downtown Denver, Denver Health is just minutes away from many of the cultural and recreational activities Denver has to offer.
Denver Health is an equal opportunity employer (EOE). We value the unique ideas, talents and contributions reflective of the needs of our community.
Applicants will be considered until the position is filled.
We are here for life’s journey.
Where is your life journey taking you?
Being the heartbeat of Denver means our heart reflects something bigger than ourselves, something that connects us all:
Humanity in action, Triumph in hardship, Transformation in health.
Department
Admissions & Registration Scvs
Job Summary
Under minimal supervision, collects comprehensive demographic and insurance information required for facilitating timely and accurate billing of patients presenting for services. Verifies and identifies patient payer sources and obtains insurance authorizations for patients admitted to the hospital/emergency department or referred to ancillary /specialty services. Performs the appropriate notification of admission (NOA) to payers for their members who are admitted to Denver Health for ongoing treatment and services. Documents gathered patient authorization information.
Essential Functions
- Verifies and identifies patient payer sources and obtains insurance authorizations for patients admitted to the hospital/emergency department or referred to ancillary /specialty services. (20%)
- Provides NOA to commercial payers for members who are admitted to the Denver Health. (15%)
- Review and respond to emails or requests from clinics or the Case Management team to confirm benefits and eligibility or completion of a timely NOA, insurance authorization, and accurate billing of patients presenting for services. Serves as a subject matter expert for all departments regarding insurance payors, RTE and RTA. (15%)
- Daily review and monitoring of assigned work queue volumes. (10%)
- Reviewing benefits summary with patients to insure understanding of their plan information and required out of pocket expenses. Will also discuss any policy limitations patients may have within their specified plan. (10%)
- Liaison with insurance companies to coordinate timely processing of claims. Ensures accuracy of authorization requests including but not limited to CPT code submission, medical notes, referrals, orders, imaging as required for insurance authorization submission. (20%)
- Ensures correct payor is identified prior to services & provides training to Patient Access team members when needed (5%)
- Coordinate peer to peer communication between clinical staff and payor (5%)
- No High School Diploma and/or No GED Required
- 1-3 years relevant experience in a customer-service business Required
- Experience may be substituted for college requirements.
- Hospital/medical office setting preferred.
Knowledge, Skills and Abilities:
- Ability to type 25 wpm.
- Ability to prioritize and perform a multitude of duties.
- Ability to relate to a diverse patient population.
- Excellent telephone and customer service skills.
- Critical analytical/investigative thinking skills.
- Some knowledge of basic medical terminology, as well as anatomy and physiology.
- Some knowledge of insurance concepts, practice, and procedures.
- Proficient in Microsoft Office Suite.
- Familiarity with Epic.
- Familiarity with insurance portals.
Days (United States of America)
Work Type
Regular
Salary
Benefits
- Outstanding benefits including up to 27 paid days off per year, immediate retirement plan employer contribution up to 9.5%, and generous medical plans
- Free RTD EcoPass (public transportation)
- On-site employee fitness center and wellness classes
- Childcare discount programs & exclusive perks on large brands, travel, and more
- Tuition reimbursement & assistance
- Education & development opportunities including career pathways and coaching
- Professional clinical advancement program & shared governance
- Public Service Loan Forgiveness (PSLF) eligible employer free student loan coaching and assistance navigating the PSLF program
- National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligible employer
- Respect
- Belonging
- Accountability
- Transparency
Denver Health is an integrated, high-quality academic health care system considered a model for the nation that includes a Level I Trauma Center, a 555-bed acute care medical center, Denver’s 911 emergency medical response system, 10 family health centers, 19 school-based health centers, Rocky Mountain Poison & Drug Safety, a Public Health Institute, an HMO and The Denver Health Foundation.
As Colorado’s primary, and essential, safety-net institution, Denver Health is a mission-driven organization that has provided billions in uncompensated care for the uninsured. Denver Health is viewed as an Anchor Institution for the community, focusing on hiring and purchasing locally as applicable, serving as a pillar for community needs, and caring for more than 185,000 individuals and 67,000 children a year.
Located near downtown Denver, Denver Health is just minutes away from many of the cultural and recreational activities Denver has to offer.
Denver Health is an equal opportunity employer (EOE). We value the unique ideas, talents and contributions reflective of the needs of our community.
Applicants will be considered until the position is filled.
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