Patient Access Representative

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This position is Benefit eligible; click here for an overview of available benefits.
This position is covered by the UHP Bargaining Unit; click here to review the current UHP Contract.
This position is in salary group UHP-03; click here to review the current UHP Pay Plan.

UConn Health is a vibrant, integrated academic medical center that is entering an era of unprecedented growth in all three areas of its mission: academics, research, and clinical care. A commitment to human health and well-being has been of utmost importance to UConn Health since the founding of the University of Connecticut schools of Medicine and Dental Medicine in 1961. Based on a strong foundation of groundbreaking research, first-rate education, and quality clinical care, we have expanded our medical missions over the decades. In just over 50 years, UConn Health has evolved to encompass more research endeavors, to provide more ways to access our superior care, and to innovate both practical medicine and our methods of educating the practitioners of tomorrow.

At the UCHC, this class is accountable for performing a full range of tasks in obtaining insurance referrals from physician's offices and insurance companies and initiating follow-up on required pre-certifications for scheduled admissions and procedures in coordination with those offices

Works under the general supervision of an employee of a higher grade.

May lead/supervise lower level employees as assigned.

• Identifies visits/procedures requiring prior approval.

• Utilizing knowledge of ICD-9, CPT coding and medical terminology, obtains required referral/prior authorization from insurance companies prior to date of service.

• Communicates with physician and medical providers regarding clinical clarifications to facilitate requests.

• Interviews patient via visits or phone to determine payment sources and payment arrangements.

• Verifies patient's benefits with insurance companies as needed.

• Refers uninsured and underinsured patients to financial counselors as identified.

• Assists in the appeals process for denied claims.

• Documents daily activities in the computer system.

• Communicates with departments regarding authorization status.

• Researches requests for patient information and prepares reports and correspondence.

• Maintains records and files may perform receptionist/triage duties.

• Performs related duties as required.

• Working knowledge of a managed care environment, third party reimbursement, hospital and community services and hospital and health care policies.

• Basic knowledge of medical coding and medical terminology.

• Skill in articulating information in a clear and informative manner to patients, family members, insurers, staff and other relevant parties.

• Organizational skills.

• Computer skills.

• Ability to gather and record all appropriate information that provides for the accurate billing and collection for provided services.

• Ability to interpret basic Medicare/Medicaid, and commercial insurance industry regulations.

Three (3) years of experience processing medical pre-authorization, insurance verification and/or medical claims for healthcare services.

Associate's degree and one (1) year of the experience as listed above may be substituted for the general experience.

SCHEDULE: Full-time, 40 hours per week, Monday through Friday from 8:30 am to 5:00 pm.