Authorization Representative — UPS Orthopaedics

Join Cleveland Clinic Union Hospital and experience world class healthcare at its best. Located in Dover, Ohio, the award-winning not-for-profit Union Hospital serves the communities of eastern Ohio. Here, you will be part of a talented, compassionate, and driven team of caregivers, work with state-of-the-art technology and provide stellar patient care.  

As an Authorization Representative for Union Physician Services in the Orthopaedics department, you are responsible for managing all functions related to workers’ compensation. You will schedule workers’ compensation for patients, submit claims and complete all required documentation in accordance with regulatory and organizational standards. You collaborate with Human Resources and employers to obtain necessary paperwork, coordinate care discussions with providers, and seek authorization for services related to workers’ compensation. You also facilitate communication by transferring phone calls appropriately and working directly with physicians to provide updates on patient status and services rendered. This position delivers a comprehensive range of insurance authorization services to support timely and compliant care delivery for injured workers.

A caregiver in this role works days from 8:00 a.m. – 5:00 p.m.

A caregiver who excels in this role will:  

• Provide a comprehensive set of insurance authorization services.  

• Crosstrain staff in all areas of authorization supporting any facility, such as verification, pre-certification, eligibility and benefits. 

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

• Flag accounts for high dollar financial clearance.  

• Perform registration input to ensure accurate patient information for the authorization process.  

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

• Schedule workers’ compensation patients, submit claims and complete all required documentation in accordance with regulatory and organizational standards.

Minimum qualifications for the ideal future caregiver include:  

• High School Diploma or GED and two years of experience in a customer-facing role with in-person or phone contact OR Associate’s Degree and one year of experience OR Bachelor’s Degree 

• Demonstrated PC skills 

• Handle multiple accounts in high volume insurance verification processes 

Our caregivers continue to create the best outcomes for our patients across each of our facilities. Click the link and see how we’re dedicated to providing what matters most to you: https://jobs.clevelandclinic.org/benefits-2/

Physical Requirements:

• Ability to communicate and exchange accurate information. 

• Ability to perform work in a stationary position for extended periods.  

• Ability to work with physical records or operate a computer or other office equipment.  

• In some locations, ability to travel throughout the hospital system.  

• In some locations ability to move up to 25 lbs.

Personal Protective Equipment:

• Follows Standard Precautions using personal protective equipment.