Insurance Representative II

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. Position Highlights Position: Insurance Representative II Location: Skokie, IL Full Time 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: Associates Degree Health Administration Required Or Associates Degree Finance Required Or Bachelors Degree Health Administration Preferred Or Bachelors Degree Finance Preferred Experience: 2 Years of experience in insurance claims management and billing, preferably in a healthcare or hospital setting. 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 EOE: Race/Color/Sex/Sexual Orientation/ Gender Identity/Religion/National Origin/Disability/Vets, VEVRRA Federal Contractor #J-18808-Ljbffr NorthShore University HealthSystem