Clinical Nurse Specialist jobs in Tennessee

Description

Who We Are:

As the only independent and physician-led faculty practice plan of the University of Tennessee Health Science Center, University Clinical Health (UCH) offers best-in-class clinical care through a network of 175 providers across 19 specialties to meet the healthcare needs of the Mid-South community. UCH is a not-for-profit, non-tax-supported group practice and is here to serve the community while providing medical excellence to our patients. 

Position Summary:

This Authorization Administrator (AA) is responsible for insurance verification, benefit checking, authorization procurement, patient liability determination, and appointment linkage in IDX and NextGen of outpatient visits. In addition, the AA will manage authorization denials for UCH practices and authorization adjustments. The AA will serve as the subject matter expert and resource for Authorization Specialists. 

Key Results Areas (KRAs):

• Versed on authorization and referral requirements for each insurance carrier
• Update authorizations and referrals in IDX
• Insurance verification through the payer website, phone numbers, and/or Passport tool
• Insurance benefits review
• Patient liability determination
• Other duties as assigned 

Core Competencies 

• Excellent verbal and written communication skills
• Strong attention to detail and accuracy to maintain data integrity
• Strong commitment to efficiency and quality results
• Ability to build and manage positive relations with clinic staff 
• Committed to supporting UCH’s standard of medical excellence

Requirements

Education & Experience:

• High school diploma or equivalent required
• Minimum of 2 years experience in customer service required
• Minimum 1-year experience working in Microsoft Office Systems Preferred
• Knowledge of medical terminology, referral and authorization process, payer benefits, and medical billing and insurance claim filing is a plus.
• Computer proficiency in Microsoft Word, Excel, and payer websites, IDX NextGen, and Passport a plus

EOE-University Clinical Health provides equal employment opportunities to all employees and applicants for employment. It prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability status, protected veteran status, genetic information, or any other characteristic protected by federal, state, or local laws. University Clinical Health is a VEVRAA Federal Contractor – priority referral Protected Veterans requested.