Insurance Verification Representative

About Humboldt Park Health As a community based hospital, Humboldt Park Health reinvests back into the community through programs to serve the poor and uninsured, manage chronic conditions like diabetes, health education and promote initiatives and outreach for the elderly. And we work hard every day to be a place of healing, caring and connection for patients and families in the community we call home. From its start in 1894, Humboldt Park Health has been deeply committed to serving the Humboldt Park community. Humboldt Park Health is a 200-bed, acute care facility. We provide healthcare treatment that's patient-centered and focused on quality of care, ranging from everyday care to treatment for your most critical needs. Join a Team That Cares for You, Too Caring for others starts with supporting the people who make it possible. We are committed to supporting our employees with meaningful benefits, retirement planning support, and opportunities for continued growth and development. Whether you are seeking a full-time, part-time, or PRN role, you'll be part of a compassionate, team-oriented environment dedicated to caring for both our patients and our staff. Full-Time Employees Benefits may include: Comprehensive health coverage including medical, dental, and vision Employer-paid Life and AD&D Insurance Flexible Spending Account (FSA) options 403(b) retirement plan with employer match Paid Time Off (PTO) that increases with years of service Education reimbursement, subject to eligibility Employee wellness programs Additional voluntary benefits Schedule: This position follows a full-time schedule with hours of 7:00am - 3:30pm . No weekends or holidays are required. Flexibility may be required based on patient and operational needs. Essential Duties and Responsibilities: Consistently demonstrates professional and customer service focused behavior at all times, including manner of communication, responsibility and appearance. Calls insurance company, or verifies online, to obtain eligibility and benefit information for all inpatients admitted day(s) prior since last business working day, all outpatient surgeries and all future pre-admissions and outpatient test/procedures. Checks daily admission reports, and/or surgical procedures, outpatient schedules to ensure all patients are accounted for. Calls, or obtains online, any required referrals, pre-authorizations or pre-certifications, RQI or tracking numbers for applicable accounts to assure reimbursement and minimize denials. Enters complete and accurate notes in HWS regarding benefits, pre-authorizations, UR review requirements, patient payment arrangements and other pertinent information in a timely manner. Reviews and updates incorrect patient, guarantor or insurance information entered in the Meditech Expanse Admissions module as necessary. Uses existing tools/resources I order to minimize denial of claim/lost revenue. Calls patients with group or private health insurance that has a deductible, co-pay or co-insurance to meet, explains benefits and payment options and makes appropriate deposit and initial payment arrangements or provides information about our financial assistance program. Refers to Financial Counselor any patient who expresses reluctance, difficulty or concerns with regard to timely payment of existing financial liabilities. Refers to Financial Counselor any patient whose benefits are inadequate, terminated or whose benefits cannot be verified after checking for further or new information with the patient, the patient's employer or any other available resource. Follows up with insured patients involving third party liability (WC, personal injury, auto accident, etc.) and ensures appropriate forms are completed and signed (as necessary) and scanned into HWS. Notifies appropriate individuals (Case Manager and/or Mgr, Physician, etc) whenever a Medicare inpatient has 5 or less available benefit days and/or patient's insurance is terminated. Obtains consent to use Lifetime Reserve Days for Medicare patients who have exhausted available renewable benefit days. Notifies director regarding admission and registration quality and assists in identifying potential performance issues and training and educational opportunities. Performs other duties as requested by director. Qualifications: Required experience includes prior experience with prior authorization for outpatient procedures. Experience with inpatient prior authorizations is also highly preferred. The hospital prohibits discrimination based on age, race, ethnicity, religion, culture, language, physical or mental disability, socioeconomic status, sex, sexual orientation, and gender identity or expression. Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.