Additional Info

General Position Information


Position Number: 00071087Working Title: Insurance Associate
Department Name: MMI Patient Information Office UNMCReports To Title: Provider Enroll/Authorization Supervisor

Position Description Details


Responsibilities and Duties


RESPONSIBILITYTIME SPENT PERCENTAGEESSENTIAL FUNCTIONTASKS
Insurance verification35X
  1. Obtains client demographic/insurance information for registration and billing & updates EPIC. (E)
  2. Ensures accuracy of patient registrations and resolves errors prior clinic appointments. (E)
  3. Confirms insurance coverage and verifies eligibility for all scheduled services prior to appointment. (E)
  4. Builds P/F and B/H accounts with updated insurance information for all scheduled services in EPIC. (E)
Preauthorization of services30X
  1. Coordinates and obtain authorizations needed for various insurance companies. (E)
  2. Pre-populates information on outpatient treatment request OTR forms for providers to submit to insurance companies. (E)
  3. Creates and submits pre-authorization requirement letters to referring physicians. (E)
  4. Submits pre-authorization requests online and via fax to insurance companies. (E)
  5. Coordinates with insurance companies, and follows up on outstanding Rx for services, pre-authorizations, and outpatient treatment requests. (E)
Processes Incoming Orders from Referring physicians30X
  1. Enters orders from physicians and other referral sources into EPIC. (E)
  2. Monitors and maintains Referral Work queues in EPIC.  
  3. Coordinates with referring physicians to obtain medical RX required for service. (E)
  4. Coordinates with insurance companies to obtain pre-determination, pre-authorization of service.
Other duties as assigned5X
  1. Backup for concierge desk(s) and medical reception desks.
  2. Backup for answering phone. 
  3. Other duties as assigned.

Zone Definition Factors


Impact


How quickly is the overall correctness of the work of an incumbent in this position typically determined?:

Determined within a relatively short period of time


Include budget dollars, value of assets, and impact in terms of organizational exposure to risk/liability.

Describe the budgetary accountabilities for this position:

Physician dissatisfaction, Customer dissatisfaction, Loss of clinical revenue


What impact do the decisions/recommendations made by the position have on the department/campus?:

Minimal


Contacts and Communications


TYPE OF CONTACTLEVEL OF CONTACTFREQUENCY OF CONTACTPURPOSE OF CONTACT
MMI Physicians & Service providersWithin DepartmentDailyCoordination of Clinical Schedules
Patients/FamiliesExternal to UNMCDailyReferral/Scheduling/Information on Services
Referring PhysiciansExternal to UNMCDailyReferral / Scheduling / Information on Services / Prescriptions & Authorizations
Insurance companiesExternal to UNMCDailyCoordinates and obtain authorizations
Local School PersonnelExternal to UNMCAs neededReferral/Scheduling/Information on Services

Supervision Received


The position works under general supervision, with assignments based on departmental goals. Employees are expected to manage routine duties and projects independently, with progress reviewed through regular meetings and periodic evaluations.


Supervision Exercised


Does this position supervise?:

No


Type of Supervision Exercised:

No Supervision:
This role does not have supervisory responsibilities but may work collaboratively with colleagues and offer informal guidance when appropriate.


Work Environment & Physical Demands


Working Environment


Office


Activity Frequency


Sit: Frequently (34-66%)Bending: Occasionally (1-33%)
Stand: Occasionally (1-33%)Kneeling: Not Required
Walk: Occasionally (1-33%)Reaching: Occasionally (1-33%)
Drive Motor Vehicle: Not RequiredCrawling: Not Required
Squatting: Not RequiredClimbing: Not Required

If other, please explain:

NA


Lift, Carry, Push, Pull Activity


Lift: Occasionally (1-33%)  10 lbsPush: Occasionally (1-33%)  10 lbs
Carry: Occasionally (1-33%)  10 lbsPull: Occasionally (1-33%)  10 lbs

If other Lift, Carry, Push, Pull, please explain:

NA


Exposure


Animals (Category 1): NOMoving Machinery: NO
Animals (Category 3): NOBiohazardous Material: NO
Blood & Bloody Fluids: NOUncomfortable temperature/ humidity: NO
Radiation/ Radioactive: NONoise: NO
Chemical Hazards: NOWorking from Heights: NO
Electrical Hazards: NOConfined Space: NO
3B or Class 4 Laser: NODust and Dusty environments: NO
Hot Work: NO

If other exposure, please explain:

NA


Use of Protective Equipment


Hearing Protection: NOEye Protection: NO
Half or Full Face Reusable Respirator: NOProtective Clothing: NO

If other protection, please explain:

NA


Use of Hands/ Wrists


Keyboard: YESPipefitting: NO
Fine Manipulation: YESGrasping: YES
Repetitive Motion: YES

If other use of hands/ wrists, please explain:

NA


Sensory


Ability to Speak: YESDepth Perception: NO
Hearing: YESDistant Vision: NO
Sight: YESNear Vision: YES
Color Vision: NOPeripheral Vision: YES

Emergency Conditions


During emergency conditions due to severe weather, natural disasters, major utility failures, or other unplanned events, certain personnel are activated to minimizethe impacts of emergencies and disasters, and to protect people, property, and restore the primary mission of the University of Nebraska Medical Center.These personnel occupy positions which are designated as 'Essential Positions.'

Essential:

NO