[Hiring] Insurance Clearance Rep Sr @Advocate Health

Role Description

This is a full-time remote role in the Enterprise Revenue Cycle - PreArrival Authorization department, working Monday to Friday from 08:30 to 17:00.

• Acquires and maintains knowledge of payor requirements related to authorizations and hospital billing.
• Performs insurance authorization for inpatient and outpatient services by collecting and analyzing clinical data.
• Consults with patients regarding uninsured status, uncovered services, and provides next steps.
• Maintains knowledge of software programs to verify eligibility and authorization.
• Ensures compliance with policies for notification of the Primary Care Physician in HMO cases.
• Identifies at-risk balances related to Medicaid eligibility rules and communicates with relevant departments.
• Manages incoming and outgoing calls for pre-registration with patients.
• Pre-registers and registers patients using established procedures for computer entry.
• Generates and processes required documents for registration and educates patients on necessary forms.
• Participates in department meetings and seeks continuing education opportunities.
• Attends mandatory in-services and participates in group projects to solve department issues.
• Maintains operational knowledge of various Advocate Aurora Health departments.
• Maintains confidentiality of patient records following HIPAA and compliance policies.

Qualifications

• High School Graduate.
• Typically requires 2 years of experience in health care, insurance industry, call center, or customer service setting.

Requirements

• Ability to problem solve in a high-profile and high-stress area.
• Ability to prioritize and organize workload.
• Mathematical aptitude, effective communication, and critical thinking skills.
• Understanding of basic human anatomy and medical terminology.
• Excellent verbal and written communication skills.
• General computer knowledge.
• Must be able to sit most of the workday.
• May include intermittent light travel.

Benefits

• Base compensation based on qualifications, skills, relevant experience, and/or training.
• Premium pay for shifts, on-call, and other roles.
• Incentive pay for select positions.
• Opportunity for annual increases based on performance.
• Paid Time Off programs.
• Health and welfare benefits including medical, dental, vision, life, and disability.
• Flexible Spending Accounts for eligible health care and dependent care expenses.
• Family benefits such as adoption assistance and paid parental leave.
• Defined contribution retirement plans with employer match.
• Educational Assistance Program.