Insurance Verification Representative - Chicago, United States - Community First Medical Center

Community First Medical Center

Verified Company

Chicago, United States

3 weeks ago

Posted by:

Mark Lane

beBee recruiter

Description

Under general direction, coordinates all financial aspects of patient visits and admissions, including insurance verification, pre-certification information, follow-up of third-party payment denials, and financial counseling.

Pre-Cert Representative will work in our Patient Access Department and is responsible for pre-certifying/pre-authorizing Inpatient and Outpatient Admissions, Inpatient and Outpatient Surgeries, MRIs, and CTs.

_ This is a full time, 8am-4:
30pm, opportunity._

ESSENTIAL DUTIES AND RESPONSIBILITIES

The insurance verification Representative is responsible for verifying patient insurance coverage, to ensure necessary procedures are covered by an individual's provider.

This position requires professionals to spend extensive amounts of time on the phone with insurance companies.

Performs telephonic support for online authorization of routine services.
Provides direct support to Primary Care practices and specialty care providers.
Authorize referral activities, and enter appropriate CPT codes.
Data entry referrals for noncomplex services including inpatient and outpatient care.
Provides data entry for care which has been arranged by the Pre-Authorization team.
Contacts providers with authorization, denial, and appeals process information.
Assists in educating and acts as a resource to primary care practices.
Verifies eligibility of members and participating status of providers.
Determines member benefit coverage.

Community First Medical Center offers benefits to all its full-time and part-time employees:

United Healthcare Medical PPO/HMO Plans| MetLife Dental |MetLife Vision| 6 Paid Holidays | Paid Time Off | Company Paid Short-term & Long-term Disability | Company Paid Life Insurance | 401(k) | Voluntary Benefits:

Hospital Indemnity & Critical Illness

Requirements:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.

Education and Experience

High school diploma or equivalent
1+ years related experience of precert experience, including navigating websites for online benefit.
Knowledge of Medical Terminology, familiarity with contract interpretation.
Good verbal and written communication skills and Accounting skills
Demonstrated knowledge of benefit plans

**Community First Medical Center is an affirmative action/equal opportunity employer who is committed to cultivating diversity, equity and inclusion within all aspects of our organizations. We stand against and prohibit discrimination in hiring or employment on the basis of age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation or any other protected status.