Insurance Representative II

Nevada System of Higher EducationSkokie, IL
$21 - $30Onsite

About The Position

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.

Requirements

  • Associates Degree in Health Administration or Finance
  • 2 Years of experience in insurance claims management and billing, preferably in a healthcare or hospital setting.

Nice To Haves

  • Bachelors Degree in Health Administration or Finance

Responsibilities

  • 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.

Benefits

  • 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
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