Insurance Verification Representative - UHealth SoLé Mia

The University of Miami UHealth at SoLé Mia opening September 2025, will bring high-quality academic medicine to North Miami, Aventura, and surrounding communities. Our expert team of physicians and staff will represent a wide range of specialties, including NCI–designated Sylvester Comprehensive Cancer Center and Bascom Palmer Eye Institute, the number one eye hospital in the nation. UHealth at SoLé Mia will also deliver the latest in urologic treatments from the renowned Desai Sethi Urology Institute as well as top‑notch care from UHealth’s nationally ranked neurology and neurosurgery programs.

UHealth at SoLe Mia has an exciting opportunity for a full-time Insurance Verification Representative to work remotely.

The individual in this position is part of the Central Insurance Verification (CIV) department and will be responsible for supporting functions that assist in creating and driving a culture of empathy, service excellence and delivery of patient centered care that impacts the patient experience across the UHealth System. Our Department thrives on teamwork and collaboration, and we know our employees achieve the greatest results when they are working together for a common goal
-to provide care for our patients. If you enjoy working in a collaborative environment then we have a job for you! This position is responsible for the verification of insurance eligibility, benefits and obtaining authorization for all insurance carriers for all outpatient office visits and procedures scheduled within the UHealth Systems. The person in this position must project a positive image of the organization and department.

This position directly impacts patient care, patient satisfaction and the revenue cycle. This individual reports directly to the Insurance Verification Supervisor.

• Accounts are completed in a timely manner in support of patient satisfaction and allow for referral and authorization activities prior to the patient’s date of service
• Verification of eligibility and benefits via RTE in UChart, online insurance websites, telephone or other source of automated services
• Add and/or edit insurance information in UChart such as validating that the correct guarantor account and plan listed in patient’s account with accurate subscriber information, policy number, and claims address and plan order.
• Completes the checklist and document co-pay.
• Creates referral if applicable, “Benefit only” or “Preauthorization”, and documents benefits information: deductible, co-insurance and out of pocket benefits
• Meets productivity standards for assigned work queue, QA goal of 95% or greater and maintains WQ current at 14 days out with minimum daily pending visits
• Assists in educating and acts as a resource to patients, primary care and specialty care practices within the UHealth system and externally
• Contact Primary Care Physician offices and/or Health Plans to obtain authorization or referral for scheduled services according to authorization guidelines listed in UHealth Contract Summary.
• Submits all necessary documentation required to process authorization request 2
• Obtains authorization for both facility and provider for POS 22 and POS 19 clinics and provider only for POS 11 clinic locations
• Enters and attaches authorization information in referral section of UChart
• Communicates with patients and/or departments regarding authorization denial and/or re-direction of patients by health plan or PCP office
• Contact the Departments and/or patient when additional information is required of them or to alert regarding pending authorization status
• Participates in process improvement initiatives 15%
• Customer Service Provides customer service and assists patients and other UHealth staff with…