Insurance Verifier

Position Title: Insurance Verifier

Full-time

Day Shift

Compensation: $22.29 hr - $26.74hr.

Saint Anthony Hospital is a diverse and community-centric organization your career can thrive in, while addressing the health and wellness challenges that families in our neighborhood face. Our employees deliver on our mission and achieve success by working together to provide excellent customer service and patient care.

As part of Saint Anthony Hospital's commitment to providing the highest quality health care, we will be building a new state-of-the-art hospital to serve as an anchor to the Focal Point Community Campus. Learn more at focalpointchicago.org.

Position Purpose:

Insurance Verification & Eligibility
• Verify insurance eligibility and benefits for all assigned inpatient and observation accounts.
• Re-verify insurance coverage when patients transition into a new calendar month to ensure continued eligibility and prevent billing denials.
• Review and update insurance information accurately within Meditech Expanse.
• Identify discrepancies in coverage, subscriber information, coordination of benefits, or registration data.
• Review payer requirements for inpatient admissions, observation stays, and specialty services.

Authorization Management
• Obtain, review, document, and track prior authorizations and inpatient notifications as required by payers.
• Monitor authorization status throughout the patient stay and ensure extensions or updates are obtained timely.
• Communicate authorization concerns, delays, or denials to appropriate departments promptly.
• Maintain accurate authorization documentation within Meditech Expanse.

Account Review & Error Identification
• Missing or incorrect insurance information
• Conduct daily account audits to identify
• Coverage termination issues
• Authorization deficiencies
• Registration inaccuracies
• Incorrect patient class or financial data
• Report identified workflow or registration errors to direct leadership for corrective action and process improvement.
• Escalate high-risk accounts that may impact reimbursement or patient care.

Collaboration & Communication
• Work collaboratively with:
• Registration
• Financial Counseling
• Case Management
• Utilization Review
• Nursing Units
• Patient Financial Services
• Provide timely updates regarding insurance or authorization barriers impacting patient care or reimbursement.
• Assist departments with payer requirement clarification and insurance-related questions.

Documentation & Compliance
• Maintain complete, accurate, and timely documentation within Meditech Expanse.
• Ensure compliance with hospital policies, payer regulations, HIPAA guidelines, and departmental workflows.
• Meet productivity and quality standards established by leadership.
• Performs other duties as requested by Manager/Supervisor.

Requirements

This position requires a rotating schedule, including rotating weekdays, weekends, and holidays as assigned.
• Rotational coverage is necessary to ensure continuous monitoring of:
• New month insurance eligibility changes
• Inpatient authorization updates
• Observation stay reviews
• Time-sensitive payer requirements
• Flexibility to support departmental operational needs is required.
• Ability to communicate effectively & timely
• Ability to work closely with other departments to ensure timely reimbursement
• One or more years of insurance verification experience.
• High school diploma or equivalent.

Saint Anthony Hospital Highlights:
• Saint Anthony Hospital is an independent, nonprofit, faith-based, acute care, community hospital dedicated to improving the health and wellness of families on the West Side and Southwest Side of Chicago.
• Saint Anthony Hospital has been certified as a Primary Stroke Center by The Joint Commission.
• Saint Anthony Hospital offers competitive wages and a comprehensive benefits program for employees and their families.
• Saint Anthony Hospital employs and teaches some of the city's brightest, most innovative resident physicians and medical students.