Insurance Pre-Authorization Representative

NorthShore University HealthSystem; Warrenville (IL); In loco; USD 28.000 - 40.000; Tempo pieno

Vantaggi offerti da questo lavoro

Free Parking

Tuition Reimbursement

Wellness Savings Plan

Health Savings Account

Descrizione del lavoro

Endeavor Health in Warrenville, IL is seeking an Insurance Pre-Authorization Representative to join our team. This full-time role requires processing referrals, pre-authorizations, and FMLA/disability forms with attention to payer criteria and turnaround times.

The position emphasizes strong customer service, confidentiality, and the ability to multi-task in a fast-paced medical office environment, with a schedule Monday to Friday, no weekends or on-call required.

Competenze

• Associate's degree preferred and Epic experience helpful.
• Proven customer service experience in a medical setting.
• Knowledge of FMLA/Disability processes is a plus.

Mansioni

• Prepare referrals and authorization forms per payer criteria and timelines.
• Handle pre-authorizations and FMLA/disability forms for designated providers.
• Prioritize requests based on medical necessity and urgency.
• Communicate status of authorizations to patients, physicians and staff.
• Respond to calls, emails, and tasks within established timeframes.
• Collaborate with hospital departments and external offices.
• Maintain patient confidentiality and compliance with guidelines.

Conoscenze

Customer service

Detail oriented

Multi-tasking

Oral & written communication

Confidentiality

FMLA/Disability knowledge

Medical terminology

Bilingual

Formazione

Associate's degree

Strumenti

Epic

Descrizione del lavoro

Hourly Pay Range:

$20.29 - $29.42 - The hourly pay rate offered is determined by a candidate's expertise and years of experience, among other factors.

Position Highlights:

• Position: Insurance Pre- Authorization Representative
• Location: Warrenville, IL
• Full Time: 40 hours / weekly
• Hours: Monday - Friday 8:00 AM - 4:30 PM. No Weekends, Holidays (excluding eves), or On-Call Schedule

What you will do:

• Prepares referrals/FMLA/disability forms per payer criteria for designated providers ensuring timely response to requests and meets established turnaround time.
• Prepares pre-authorizations and FMLA/disability forms per health care guidelines/established laws for designated providers to build timely approvals/forms completion in order to preserve and generate revenue and maintain patient satisfaction.
• Prioritizes the processing of referral requests/FMLA disability forms based on medical necessity and/or urgency of the patient case.
• Communicates status of authorization/FMLA disability forms (approvals, denials, pending) to patients, physicians and other clinical staff.
• Addresses all tasks, phone calls, voicemail and e-mail within established timeframes and per current department guidelines
• Collaborates with physicians and staff as well as outside offices to obtain needed information.
• Establishes, develops and maintains good working relationships with hospital departments, health plan representatives and physician office personnel as well as a high degree of customer service/recovery skills.
• Maintains patient confidentiality

What you will need:

• Associate's degree Preferred
• 1 Year of experience in a medical office setting And
• 1 Year Prior Epic experience
• Strong customer service focus
• Detail oriented
• Ability to multi-task and work in a fast paced environment
• Strong oral and written communication skills
• Ability to maintain confidentiality
• High level of understanding of FMLA/Disability laws and processes
• Medical terminology
• Bilingual

Benefits (For full time or part time positions):

• Career Pathways to Promote Professional Growth and Development
• Various Medical, Dental, Pet and Vision options
• Tuition Reimbursement
• Free Parking
• Wellness Program Savings Plan
• Health Savings Account Options
• Retirement Options with Company Match
• Paid Time Off and Holiday Pay
• Community Involvement Opportunities

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.

When you work for Endeavor Health, you will be part of an organization that encourages its employees to achieve career goals and maximize their professional potential.

Please explore our website (www.endeavorhealth.org) to better understand how Endeavor Health delivers on its mission to "help everyone in our communities be their best".

Endeavor Health is committed to working with and providing reasonable accommodation to individuals with disabilities. Please refer to the main career page for more information.

At Endeavor Health, we are united by a shared commitment to working together to create a culture of connection and belonging-each of us bringing different skills and experiences as we deliver safe, seamless, and personal care. Every person, every time. We are committed to fostering an environment where all team members can be their best, learn, and pursue excellence together.

EOE: Race/Color/Sex/Sexual Orientation/ Gender Identity/Religion/National Origin/Disability/Vets, VEVRRA Federal Contractor.