Insurance Representative II

Position Highlights

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

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.