Insurance Verifier

Prime Healthcare; Chicago, Northern (IL, KY); On-site; USD 23,000 - 33,000; Full time

Job summary

Prime Healthcare's Saint Mary of Nazareth Hospital in Chicago, IL seeks an Insurance Verification Specialist for full-time days (7am-3:30pm). You will verify eligibility, explain coverage to patients, coordinate pre-service payments, collect funds, and manage EMR records with a focus on accurate reimbursement.

The role requires 2+ years in admissions or billing, plus knowledge of payer processes and medical terminology. Excellent organization and communication are essential for success.

Qualifications

• Minimum two years' experience in hospital admissions or billing setting preferred.
• Well versed in authorization processes for all payers.
• Knowledge of medical terminology and insurance policies.
• Excellent organization and time management skills along with excellent oral and written communication skills.
• Ability to learn quickly, work independently and collaborative within a team environment.
• Ability to maintain good working relationships.
• Demonstrates attention to detail and ability to multitask.
• Ability to work in a demanding environment.
• Problem solving skills.
• Proficient computer skills.
• High School Graduate or GED Equivalent Required (effective 4/1/14 for all new hires).

Responsibilities

• Contact health plan carriers to obtain eligibility information and verify data in the patient account.
• Assist patients in understanding their insurance coverage and financial responsibilities.
• Coordinate payments for scheduled services per payer specifications prior to services.
• Collect payments, discuss payment arrangements, and create estimates.
• Advise patients on insurance benefits coverage in person and by phone.
• Prepare reports on insurance verification activities for management.
• Maintain EMR documentation of communications and follow-ups.
• Gather information to process financial assistance requests.
• Pursue education opportunities to stay current with payer changes.

Skills

Excellent communication

Organization & time management

Attention to detail

Multitasking

Independent and collaborative work

Problem solving

Proficient computer skills

Medical terminology knowledge

Quick learner

Adaptability to a demanding hospital\-

Education

High School Graduate or GED

Tools

EMR systems

Payment processing software

Job description

Overview

Department: Admitting

Schedule: Full-time - Days, 7am-3:30pm

Facility: Saint Mary of Nazareth Hospital

Location: Chicago, IL

Responsibilities

The primary function of the insurance verification specialist is to contact health plan carriers to obtain eligibility information ensuring that the most accurate up to date information is verified and entered into patient's account. Assist patients in understanding their insurance coverage and financial responsibilities. Coordinates payment for all scheduled/elective services required according to payer specifications prior to services rendered. Collects payments, discusses payment arrangements as appropriate, creates estimates, advises patents in person and over the phone on their insurance benefits coverages and in some cases assesses and validates physician orders for appropriateness. Provide excellent customer service to patients regarding insurance inquiries. Manage any insurance related queries from internal and external stakeholders. Prepares reports on insurance verification activities and outcomes for management review. Problem solves insurance errors and research insurances requirements. Gathers all relevant information required to process financial assistance requests. Documents all communication and follow up in the EMR. Pursues and participates in education opportunities to remain current with payer changes in the healthcare industry.

Qualifications

EDUCATION, EXPERIENCE, TRAINING

1. Minimum two years' experience in hospital admissions or billing setting preferred.

2. Well versed in authorization processes for all payers

3. Knowledge of medical terminology and insurance policies

4. Excellent organization and time management skills along with excellent oral and written communication skills.

5. Ability to learn quickly, work independently and collaborative within a team environment

6. Ability to maintain good working relationships

7. Demonstrates attention to detail and ability to Multitask.

8. Ability to work in a demanding environment

9. Problem solving skills

10. Proficient computer skills

11. High School Graduate or GED Equivalent Required (effective 4/1/14 for all new hires)

The company is dedicated to empowering its staff with a comprehensive, competitive benefits package, allowing them the freedom to customize their benefits to fit their unique needs. Our abundant resources, programs, and voluntary options serve as a foundation for individual growth and well-being. Learn more here: https://www.primehealthcare.com/benefitsthatmattermost/

Pay Transparency

Saint Mary of Nazareth Hospital offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $17.25 to $24.42. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

Employment Status

Full Time

Shift

Days

Equal Employment Opportunity

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf