Insurance Verification Specialist
Prime Healthcare
Insurance Verification Specialist
Prime Healthcare
Acquires and reorganizes underperforming hospitals
Department: Admitting
Schedule: Full-time - Days
Facility: Resurrection Medical Center
Location: Chicago, IL
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.
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)
Resurrection Medical Center 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 $17.15 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.
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/
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
Acquires and reorganizes underperforming hospitals
Prime Healthcare operates a network of hospitals and outpatient centers across the United States, concentrating on turning around financially struggling facilities. It invests in infrastructure and technology, restructures operations, and negotiates payer terms (including pursuing higher out-of-network reimbursements) to improve financial performance, and it manages both for-profit hospitals and not-for-profit facilities through the Prime Healthcare Foundation. The company aims to raise clinical quality and patient safety while expanding access in hundreds of communities, though it has faced legal and regulatory scrutiny over billing practices and service-line decisions. Its goal is to stabilize and improve the financial and clinical performance of underperforming hospitals so they can continue serving their communities.
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