Children’s Hospital Colorado Looking for Insurance Verification Representative at Aurora, CO Full Time

Here, it’s different. Come join us.

Children’s Hospital Colorado has defined and delivered pediatric healthcare excellence for more than 100 years.

Here, the nation’s brightest nurses, physicians, scientists, researchers, therapists and care providers are creating the future of child health. With an optimist’s outlook, a trailblazing spirit and a celebrated history, we’re making new strides every day.

We’ve been Magnet-designated four times by the American Nurses Credentialing Center and are consistently recognized among the nation’s top 10 pediatric hospitals by U.S. News & World Report.

As a national leader in pediatric care, we serve children and families from all over the nation. Our System of Care includes four pediatric hospitals, 12 specialty care centers, 400+ outreach clinics and 7,000 healthcare professionals representing the full spectrum of pediatric care specialties.
We need your expertise.

Department: Psych Emergency Department
Hours per week: 40, eligible for benefits
Shift: 1.0 FTE, 80 hrs/PP. Monday-Friday 0645-1515.

The Insurance Verification Rep handles high risk insurance accounts in Finance. Verifies insurance policy benefit information and obtains authorization and precertification, prior to the patient’s visit or non-scheduled admission.

POPULATION SPECIFIC CARE

• No direct patient care.

ESSENTIAL FUNCTIONS

An employee in this position may be called upon to do any or all of the following essential functions. These examples do not include all of the functions which the employee may be expected to perform.

• Focuses on insurance accounts identified as high risk by the department.
• Notifies insurance company of services being rendered and obtains authorization if applicable; ensures notification, authorization and verification is completed for each account.
• Completes and obtains insurance information and referrals; verifies policy information and obtains detailed benefit information; codes work list according to departmental guidelines.
• Updates and edits coverage information on non-scheduled or pre-admitted patients.
• Assists in identifying problems; assures insurance information and appropriate referrals have been completely and accurately obtained.
• Participates in peer program development.
• Serves as a resource for co-workers and staff.
• Provides customer service in person by phone or email; assists customers, patients, families, providers, and staff with insurance questions or escalations.
• May work in conjunction with hospital departments to solve intradepartmental issues.
• Assists on special projects as assigned by the Supervisor.

COMPETENCIES

• DIVERSITY & INCLUSIVITY – Is sensitive to cultural diversity, race, gender, and other individual differences in the workforce; recognizes the value of diverse perspectives and experiences and fosters a work environment reflective of the community at large.
• BUILDING CUSTOMER LOYALTY – Meeting and exceeding internal or external customer expectations while cultivating relationships that secure commitment and trust.
• BUILDING PARTNERSHIPS – Developing and leveraging relationships within and across work groups to achieve results.
• COMMUNICATION – Conveying information and ideas clearly and concisely to individuals or groups in an engaging manner that helps them understand and retain the message; listening actively to others.
• CONTINUOUS LEARNING – Actively identifying new areas for learning; regularly creating and taking advantage of learning opportunities; using newly gained knowledge and skill on the job and learning through their application.
• DECISION MAKING – Identifying and understanding problems and opportunities by gathering, analyzing, and interpreting quantitative and qualitative information; choosing the best course of action by establishing clear decision criteria, generating and evaluating alternatives, and making timely decisions; taking action that is consistent with available facts and constraints and optimizes probable consequences.
• EMOTIONAL INTELLIGENCE – Establishing and sustaining trusting relationships by accurately perceiving and interpreting own and others’ emotions and behavior; leveraging insights to effectively manage own responses so that one’s behavior matches one’s values and delivers intended results.
• MANAGING RELATIONSHIPS – Meeting the personal needs of individuals to build trust, encourage two-way communication, and strengthen relationships
• PLANNING AND ORGANIZATION – Establishing an action plan for self and others to complete work efficiently and on time by setting priorities, establishing timelines, and leveraging resources.
• QUALITY ORIENTATION – Accomplishing tasks by considering all areas involved, no matter how detailed; showing concern for all aspects of the job; accurately checking processes and tasks; being watchful over a period of time.
• RESOLVING CONFLICT – Helping others deal effectively with an antagonistic situation to minimize damage to the relationships and promote shared goals; using appropriate interpersonal methods to reduce tension or conflict between two or more people and facilitate agreement.
• STRESS TOLERANCE – Maintaining stable performance under pressure or opposition (e.g., experiencing time pressure, conflict, or job ambiguity); handling stress in a manner that is acceptable to others and to the organization.

SCOPE AND LEVEL

• Guidelines: Guidelines are generally numerous, well established, and directly applicable to the work assignment. Work assignment and desired results are explained by general oral or written instructions.
• Complexity: Duties assigned are generally repetitive and restricted in scope but may be of substantial intricacy. Employee primarily applies standardized practices.
• Decision Making: Decisions or recommendations on non-standardized situations are limited to relating organizational policies to specific cases. Brings non routine issues to supervisor. Problems that are not covered by guidelines or are without precedent are taken up with the supervisor.
• Communications: Contacts with the public or employees where explanatory or interpretive information is exchanged, gathered, or presented and some degree of discretion and judgment are required within the parameters of the job function.
• Supervision Received: Under normal supervision, within a standardized work situation, the employee performs duties common to the line of work without close supervision or detailed instruction. Work product is subject to continual review.

• EDUCATION – High School Diploma or Equivalent
• EXPERIENCE – Two years of customer service required, including one year in a medical office setting.

Ability to Perform Essential Functions of the Job

• Audio-Visual: Hearing: Good
• Audio-Visual: Near Vision: Good
• General Activity: Sit: 2-4 hrs. per day
• Motion: Bend: Up to 1/3 of time
• Use of Hands/Feet: Precise Motor Function
• Weight Lifted/Force Exerted: Up to 30 pounds

WORK ENVIRONMENT

• Mental and Emotional Requirements: Independent discretion/decision making.
• Mental and Emotional Requirements: Makes decisions under pressure.
• Mental and Emotional Requirements: Manages stress appropriately.
• Mental and Emotional Requirements: Works with others effectively.

It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job-related factors. We do not discriminate on the basis of race, color, religion, national origin, sex, age, disability, or any other status protected by law or regulation. Be aware that none of the questions are intended to imply illegal preferences or discrimination based on non-job-related information.

Salary Information

Annual Salary Range (Based on 40 hours worked per week): $36,337.66 to $54,506.49
Hourly Salary Range: $17.47 to $26.21

Benefits Information

As a Children’s Hospital Colorado team member, you will receive a competitive pay and benefits package designed to take care of your needs that includes base pay, incentives, paid time off, medical/dental/vision insurance, company provided life and disability insurance, 403b employer match (retirement savings), and a robust wellness program.