Endeavor Health is a fully integrated healthcare delivery system committed to providing access to quality, vibrant, community-connected care, serving an area of more than 4.2 million residents across six northeast Illinois counties. Our more than 25,000 team members and more than 6,000 physicians aim to deliver transformative patient experiences and expert care close to home across more than 300 ambulatory locations and eight acute care hospitals – Edward (Naperville), Elmhurst, Evanston, Glenbrook (Glenview), Highland Park, Northwest Community (Arlington Heights), Skokie and Swedish (Chicago) – all recognized as Magnet hospitals for nursing excellence. For more information, visit www.endeavorhealth.org
Job Title: Insurance Verification Representative II
Location: Arlington Heights, IL
Full Time/Part Time: Full-time, Mon-Fri Onsite
Hours: Hours rotate Monday-Friday during normal business hours
- Reviews and analyzes all required demographic, insurance/financial, and clinical data procured by patient intake and registration areas necessary to expedite payment on patient’s accounts.
- Resolves all issues including obtaining information and signatures on documents required by the patient’s insurance carrier.
- Corrects information in both the Patient Management System and Patient Account Systems.
- Interacts, via telephone and in person, with patients, their representatives, physicians, physician’s office staff, employers, and others, and reviews new and previously recorded patient, insurance and procedural information.
- Electronically records all phone interactions and records resolution to follow-up items in a timely manner.
- Communicates hospital policies to patients or their representatives.
- Follows HIPAA, payer and applicable regulations and standards for registration and billing.
- Performs pre-certification notification via telephone or electronically and gathers and completes all required documentation for submission to insurance carriers per payer requirements.
- Enters patient procedure insurance and benefits eligibility information into the hospital Patient Management and Patient Accounting computer systems.
- Ensures patient has coverage for procedure to be performed with a minimum standard set by Access Services Policy in advance of scheduled procedure.
- Acts as a liaison between patients and physicians with insurance companies to pre-certify all inpatient, outpatient and observation procedures/cases per insurance contract requirements.
- Notifies patients, physicians and ancillary departments regarding procedures that are potentially not covered and coordinates with Financial Counselors to initiate payment plan arrangements prior to patient services being rendered
- Education: High school diploma required. Associates degree or active pursuit of a degree preferred.
- Skills:
- Ability to functionally navigate multiple computer software systems with accurate keyboard skills following computer security protocols.
- The interpersonal communication skills necessary to interview and interact with customers, physicians and insurance carriers, to project a professional and compassionate concierge style of service.
- Ability to work independently, exercising good judgment, and multi-task in a high stress, fast paced service environment with patients, physicians and insurance carriers.
- Detail oriented with good analytical problem-solving skills to appropriately register patients and schedule patient procedures.
- Ability to operate routine office equipment (facsimile, copiers, plate production, scanners, printers).
- Experience:
- Minimum 2 years of customer service work experience using computers required.
- Minimum of 2 years previous healthcare or related experience (i.e. billing, collections, insurance, and doctor’s office) and familiarity with payer requirements, regulatory compliance requirements, HIPAA privacy and security requirements, medical terminology and general revenue cycle procedures required. Prior revenue cycle work experience desired.
- Certification: n/a