Insurance Representative II

NorthShore University HealthSystem; Skokie (IL); Hybrid; USD 28,000 - 41,000; Full time

Benefits offered by this job

Premium pay based on shift

Incentive pay

Annual increases

Career growth opportunities

Medical, dental, vision

Tuition reimbursement

Free parking

Wellness program

Health savings account

Retirement with company match

Paid time off

Community involvement

Job summary

Endeavor Health in Skokie, IL seeks an Insurance Representative II to manage insurance claims, resolve billing issues, and optimize reimbursements. This full-time hybrid role supports patients and insurers while ensuring compliant claim processing.

The ideal candidate will have a high school diploma, at least 2 years in claims/billing, and knowledge of insurance regulations. Growth opportunities and comprehensive benefits are offered.

Qualifications

• High School Diploma required; associates degree preferred
• 2 years of experience in insurance claims and billing

Responsibilities

• Review and process insurance claims for accuracy and compliance
• Monitor pending claims, follow up on appeals and resubmissions
• Verify patient insurance coverage and eligibility
• Investigate and resolve claim denials and disputes with insurers
• Assist patients in understanding claims, coverage, and reimbursement
• Explain payment options and financial assistance programs
• Maintain detailed records of interactions and claim processing
• Stay updated on insurance regulations including HIPAA
• Generate reports on claim status, reimbursements, and resolutions
• Gather patient feedback for process improvement

Skills

Insurance claims management

Customer service

HIPAA knowledge

Education

High School Diploma

Associates Degree Health Administration

Associates Degree Finance

Job description

Hourly Pay Range:

$20.69 - $30.00 - The hourly pay rate offered is determined by a candidate's expertise and years of experience, among other factors.

Position Highlights:

• Position: Insurance Representative II

• Location: Skokie, IL

• Full Time, hybrid

• Hours: Monday-Friday, [hours and flexible work schedules]

A Brief Overview:

The Insurance Representative II is a key member of the hospital's financial services team, responsible for managing insurance claims and resolving billing and payment issues. This position plays a critical role in ensuring the hospital's financial success by optimizing the insurance claim process, maximizing reimbursements, and providing top-notch support to patients and insurance providers.

What you will do:

• Review and process insurance claims for accuracy, completeness, and compliance with relevant insurance policies and healthcare regulations.

• Monitor and follow up on pending insurance claims, including appeals and resubmissions, to expedite reimbursement and minimize claim denials.

• Verify patient insurance coverage, including policy details, eligibility, and benefit information, to ensure accurate claim submissions.

• Investigate and resolve claim denials and disputes, providing necessary documentation and communication with insurance companies for claim approval.

• Assist patients in understanding their insurance claims, explaining coverage and reimbursement processes, and addressing any questions or concerns.

• Provide support to patients in understanding and managing their healthcare expenses, including explaining payment options, financial assistance programs, and payment plans.

• Maintain accurate and detailed records of all interactions, claim processing, and patient communications, ensuring compliance with hospital standards and regulatory requirements.

• Stay updated on changes in insurance regulations, ensuring that claim processes align with legal and compliance standards, including HIPAA.

• Generate reports and maintain metrics related to insurance claim status, reimbursement rates, and resolution times.

• Gather and document patient feedback and suggestions, reporting relevant trends or issues to the appropriate department for process improvement.

What you will need:

• Education: High School Diploma required; Associates Degree Health Administration Or Associates Degree Finance preferred

• Experience: 2 Years of experience in insurance claims management and billing, preferably in a healthcare or hospital setting.

Benefits (For full time or part time positions):

• Premium pay such as shift, on call, holiday and more based on an employee's job (For eligible positions)

• Incentive pay for select positions

• Opportunity for annual increases based on performance

• 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