Insurance Verification Representative

Current Employees

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Core Job Summary

The Sr. Insurance Verification Representative verifies insurance eligibility and authorization for all contracted and non-contracted insurance carriers and takes appropriate steps to facilitate reimbursement to department for services rendered.

Core Job Functions

1. Verifies insurance information with patients for scheduled appointments and contacts payer to verify eligibility and authorization requirements.
2. Adds or updates financial status classifications in appropriate systems.
3. Contacts caregivers and patients for HMO payers to obtain authorizations and referrals.
4. Generates and links referrals to appropriate visit once authorization is obtained.
5. Responds to customer inquiries regarding insurance coverage of services and processing of claims.
6. Follows appropriate procedures to link alternative insurance plan payers to the appropriate programs during registration.
7. Identifies non-contracted HMO payers and refers to proper managing department.
8. Serves as a lead Insurance Verification Representative and assists in training new staff.
9. Adheres to University and unit-level policies and procedures and safeguards University assets.

Core Qualifications

Education: High School diploma or equivalent required. Experience: Minimum 3 years of relevant experience required. Certification and Licensing: Refer to department description for applicable certification requirements.

• Learning Agility: Ability to learn new procedures, technologies, and protocols, and adapt to changing priorities and work demands.
• Teamwork: Ability to work collaboratively with others and contribute to a team environment.
• Technical Proficiency: Skilled in using office software, technology, and relevant computer applications.
• Communication: Strong and clear written and verbal communication skills for interacting with colleagues and stakeholders.

This is a core job profile description and is not reflective of all duties that may be assigned to a specific position in each individual department. The above statements are intended to describe the general nature and primary responsibilities of this core job profile. Specific duties and tasks may vary based upon departmental needs. Other duties may be assigned to the above consistent with the knowledge, skills, and abilities required for the job.

The University of Miami is an Equal Opportunity Employer - Females/Minorities/Protected Veterans/Individuals with Disabilities are encouraged to apply. Applicants and employees are protected from discrimination based on certain categories protected by Federal law. Click here for additional information.

Job Status: Full time

Employee Type: Staff

Pay Grade: H4