Cleveland Clinic Authorization-Representative-1 in Cleveland, Ohio

Job Summary:

Provides a comprehensive set of insurance authorization services.

Responsibilities:

  • Cross-trained to staff all areas of Authorization supporting any facility, including but not limited to verification, pre-certification, eligibility, benefits including copays, deductibles and out of pocket expenses.

  • May be required to flag accounts for high dollar financial clearance. Identifies and utilizes appropriate reports to contact insurance payers for resolution to accounts that are pending, denied or in the appeal process.

  • Maintains productivity and quality expectations set forth by department.

  • Performs some registration input in order to ensure accurate patient information for the authorization process.

  • Identifies and utilizes appropriate reports to contact insurance payers for resolution to accounts that are pending, denied or in the appeal process.

  • Communicates with physician offices to obtain clinical information and/or coordinate peer-to-per conversations.

  • Identifies and utilizes appropriate reports to contact insurance payers for resolution to accounts that are pending, denied or in the appeal process.

  • Other duties as assigned.

Education:

  • High school diploma or equivalent.

Certifications:

  • None required.

Work Experience:

  • Minimum of 2 years of experience in a customer facing role with in person or phone contact.

  • Candidate must demonstrate PC skills efficiency.

  • Ability to multitask within multiple accounts in high volume insurance verification processes.

  • An Associate's degree may substitute for up to one year of the stated experience.

  • A Bachelor's degree my substitute for up to two years of the stated experience.

Physical Requirements:

  • Sufficient mobility and strength to move around the department and throughout the facility.

  • Ability to stand or sit for prolonged periods of time.

  • Excessive walking and standing while obtaining patient information when using laptop computer on wheeled device for bedside registration.

  • Ability to lift 25 pounds.

Personal Protective Equipment:

  • Follows Standard Precautions using personal protective equipment.

The policy of Cleveland Clinic and its system hospitals (Cleveland Clinic) is to provide equal opportunity to all of our employees and applicants for employment in our tobacco free and drug free environment. All offers of employment are followed by testing for controlled substance and nicotine. Job offers will be rescinded for candidates for employment who test positive for nicotine. Candidates for employment who are impacted by Cleveland Clinic’s Smoking Policy will be offered smoking cessation assistance and will be permitted to reapply for open positions after 90 days. Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic facility.

Cleveland Clinic is pleased to be an equal employment employer: Women/Minorities/Veterans/Individuals with Disabilities