UR Financial Clearance Spec
Company: Methodist Health System
Posted on: March 20, 2023
Why work for Nebraska Methodist Health System?At Nebraska
Methodist Health System, we focus on providing exceptional care to
the communities we serve and people we employ. We call it The
Meaning of Care - a culture that has and will continue to set us
apart. It's helping families grow by making each delivery special,
conveying a difficult diagnosis with a compassionate touch, going
above and beyond for a patient's needs, or giving a high five when
a patient beats a disease or conquers a personal health challenge.
We offer competitive pay, excellent benefits and a great work
environment where all employees are valued! Most importantly, our
employees are part of a team that makes a real difference in the
communities we live and work in.Job Summary:Responsible for
submitting insurance notification to insurers based on established
requirements in a timely and accurate manner. Assist with
verification and authorization for payment of hospital
services.Responsibilities:Essential Job FunctionsComplete
notification of patient admission following payer specific
- Use websites for notification when available.
- Collect contact information for clinical review in electronic
- Provides diagnosis and demographic information as requested by
- Complete telephonic notification and online notification for
failed UHC 278 transfers.Ensure all payer sources (commercial and
governmental) are verified as eligible.
- Complete verification process for all patient insurance if not
- Investigate and correct all application alerts.
- Ensure payment order for payers is correct.
- Confirm payer order is correct.Prioritize notifications.
- Use daily census to ensure all cases requiring notification are
completed within 24 hours of admission.
- Prioritizes notification of payers, using available contact
- Monitor reports to identify patients with change of status
requiring notification.Utilize online systems to complete
notification and precertification.Communication.
- Document complete and accurate information in Case Management
software using established abbreviations.
- Communicate directly with UR nurse unique or unusual
notification requirements.Update insurance reference guide
regularly based on changes in payer requirements.Deliver required
notification documents to patients in a timely manner based on
payer requirements.Adhere to safety and Infection Control
- Reports unsafe conditions or accidents immediately.
- Maintain a safe working environment.
- Follow established guidelines for contact with patients in
isolation.Schedule:32 hrs/week, rotating scheduled weekends and
holidaysJob Description:Job RequirementsEducation
- Associates degree in a health care related field required.
- Healthcare/ insurance experience may be considered in lieu of
- Minimum six months of insurance notification and/or
authorization experience preferred.
- Experience with online payer notification programs
- Skill with written and verbal communication.
- Skill working effectively with other employees, patients and
- Skill using Microsoft Office Suite and other specialized
- Knowledge of medical terminology.
- Ability to organize, perform and track multiple tasks
- Ability to complete work accurately and within established
- Ability to work independently and in a team.
- Ability to adapt to changing priorities.Physical
- Light Work - Exerting up to 20 pounds of force.Physical
- Not necessary for the position (0%):
- Occasionally Performed (1%-33%):
- Distinguish colors
- Frequently Performed (34%-66%):
- Repetitive Motions
- Constantly Performed (67%-100%):
- Speaking/talkingJob Hazards
- Not Related:
- Chemical agents (Toxic, Corrosive, Flammable, Latex)
- Physical hazards (noise, temperature, lighting, wet floors,
outdoors, sharps) (more than ordinary office environment)
- Explosives (pressurized gas)
- Electrical Shock/Static
- Radiation Alpha, Beta and Gamma (particles such as X-ray, CAT
scan, Gamma Knife, etc.)
- Radiation Non-Ionizing (Ultraviolet, visible light, infrared
and microwaves that causes injuries to tissue or thermal or
- Mechanical moving parts/vibrations
- Rare (1-33%): - Biological agents (primary air born and blood
born viruses) (Jobs with Patient contact) (BBF) About Methodist:
Nebraska Methodist Health System is made up of four hospitals in
Nebraska and southwest Iowa, more than 30 clinic locations, a
nursing and allied health college, and a medical supply
distributorship and central laundry facility. From the day
Methodist Hospital was chartered in 1891, service to our
communities has been a top priority. Financial assistance, health
education, outreach to our diverse communities and populations, and
other community benefit activities have always been central to our
mission.Nebraska Methodist Health System is an Affirmative
Action/Equal Opportunity Employer and does not discriminate on the
basis of race, color, religion, sex, age, national origin,
disability, veteran status, sexual orientation, gender identity, or
any other classification protected by Federal, state or local
Keywords: Methodist Health System, Omaha , UR Financial Clearance Spec, Accounting, Auditing , Omaha, Nebraska
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