Insurance Verification Representative I - Inpatient Rehab - Days
Company: Endeavor Health
Location: Rolling Meadows
Posted on: February 27, 2026
|
|
|
Job Description:
Hourly Pay Range: $19.89 - $28.84 - The hourly pay rate offered
is determined by a candidate's expertise and years of experience,
among other factors. Position Highlights: Position: Insurance
Verification Representative I Location: Northwest Community
Hospital, Arlington Heights, IL Full Time/Part Time: part-time - 32
hours per week Hours: Monday, Thursday, Friday 7:30-4 (hours
flexible). Tuesday, Wednesday 8-12:00 Required Travel: no A Brief
Overview: The Insurance Verification Representative will be under
the management of the Manager, Patient Access, the
Pre-Certification Representative I is responsible to determine
insurance eligibility and, as appropriate benefits,
pre-authorization / pre-certification and medical necessity
requirements based on patient specific insurance. The
Pre-Certification Representative I provide this service to ensure
that our customers are provided a high-quality experience which
includes understanding of patient responsibility and ease of access
to clinical services. This is achieved through coordination with
and education of the patient. The Pre-Certification Representative
I help to ensure that patient satisfaction and loyalty are achieved
while hospital and Medical Group revenue is optimized. What you
will do: Use Endeavor Health protocol to verify patient selection.
Performs online eligibility and benefit checks for applicable
payers as outlined in guidelines. Enters data accurately into Epic
in accordance with standards. Calls the insurance company directly
to obtain required eligibility and benefit information for all
managed care, governmental and commercial payers, Verifies if
pre-certification is required. Process accounts according to
performance standards - timing, volume and quality Use NorthShore
protocol to verify patient selection. Utilize established protocols
to register patient (e.g. select insurance and guarantor,
verify/enter demographic information) Provide instructions to
patient (e.g. prep instructions related to procedure, location,
co-pay) Accesses Medicare LMRP software to determine if ABN
(Advance Beneficiary Notice) is required. Ascertain medical
necessity requirements for visit utilizing NEBO Eligibility
Software. If medical necessity check fails, contact physician for
more appropriate diagnosis if available. Generate and complete ABN
when needed and contacted the ordering physician and patient as
outlined in procedural guidelines to communicate and explain
requirement. For pre-registered patients, fax the ABN to the
responsible check-in area (department or registration) for the
service. Document all activities in Epic appropriately. Process
accounts according to performance standards - timing, volume and
quality Contacts physician office or insurance company to check
status of and / or obtain existing precertification number for
ordered service. Documents obtained information including
certification number and number of days approved for inpatients
into Epic. If authorization is not obtained as required, contact
physician office and department regarding cancellation of
procedure. If authorization is not obtained due to medical
necessity, contact ordering physician's office and patient
regarding waiver requirement. Generate and forward waiver as needed
to department for patient signature. Follows standards for
documenting cases and forwarding to Financial Counseling. Identify
if callers have an existing NorthShorConnect account. If not,
introduce NorthShoreConnect and encourage patient use. Utilize Epic
to create NorthShoreConnect account for patients. Apply HIPAA
guidelines to all situations, as appropriate. Follow all NorthShore
protocols to ensure compliance with HIPAA. What you will need: High
School Required 1 Year of experience in a contact center,
healthcare environment or customer service role. And Experience
with referrals and pre-certification strongly preferred. Basic math
skills Basic computer skills Typing speed of 30 wpm Demonstrated
record of excellent customer service skills Strong verbal
communication skills: ability to speak clearly and articulate to
customers and co-workers. Strong written communication skills to
record patient activity in Epic. Strong active listening skills to
effectively assist multiple customer types and identify ""panic""
or ""hot"" words. Ability to display empathy when dealing with
customers. Critical thinking skills Decision-making and
problem-solving skills Strong attention to detail to accurately
enter data and research and resolve questions Ability to work
independently with minimal supervision. Ability to multi-task
Ability to utilize multiple computer applications and operating
system concurrently. Ability to recognize customers' anger and
attempt to defuse it. Knowledge of medical terminology and health
insurance terminology, preferred. Front desk/central scheduling
and/or registration experience, preferred. Epic experience,
preferred Benefits: Career Pathways to Promote Professional Growth
and Development Various Medical, Dental, and Vision options Tuition
Reimbursement Free Parking at designated locations Wellness Program
Savings Plan Health Savings Account Options Retirement Options with
Company Match Paid Time Off Community Involvement Opportunities
Keywords: Endeavor Health, Berwyn , Insurance Verification Representative I - Inpatient Rehab - Days, Healthcare , Rolling Meadows, Illinois