Insurance Verification Specialist

We are seeking an Insurance Analyst I to support patients and healthcare providers with insurance benefits, claims, prior authorizations, and reimbursement needs. This position is ideal for someone with healthcare call center, medical insurance, pharmacy, or claims experience who is comfortable communicating directly with insurance payers and healthcare providers.

The role will primarily involve outbound calls to insurance payers to obtain claim and authorization status, documenting updates, and creating cases to keep patients and providers informed. You will work closely with internal teams, insurance companies, and healthcare providers to help patients access and continue their prescribed therapies.

• Verify medical and prescription insurance coverage and benefits.

• Make outbound calls to insurance payers to obtain claim, coverage, and authorization status.

• Research and troubleshoot insurance billing, claims, reimbursement, and coverage issues.

• Assist healthcare provider offices throughout the prior authorization and appeals process.

• Monitor prior authorizations and appeals to help ensure timely resolution.

• Communicate referral and case status updates to patients and healthcare providers via phone, fax, and internal systems.

• Enter and maintain accurate patient demographic and insurance information.

• Research commercial and government insurance benefits and identify potential financial assistance opportunities.

• Document all interactions and case updates accurately and thoroughly.

• Manage multiple cases and priorities while meeting established productivity and quality expectations.

• Follow all applicable HIPAA, privacy, compliance, and healthcare regulations.

• Identify and appropriately report potential adverse events according to established procedures.

Hours:

Monday-Friday 7am-7pm, will be scheduled at 8 hour shift during this time

• 13 years of experience in a healthcare or reimbursement-related environment.

• Previous experience in one or more of the following:

• Healthcare call center

• Medical claims or reimbursement

• Health insurance

• Pharmacy or specialty pharmacy

• Healthcare/medical office

• Knowledge of medical and pharmacy insurance, insurance verification, claims processing, billing, prior authorizations, and appeals.

• Understanding of commercial and/or government insurance programs.

• Strong attention to detail and ability to accurately document patient and insurance information.

• Ability to manage multiple priorities and meet deadlines in a high-volume environment.

• Strong written and verbal communication skills.

• Comfortable making frequent outbound calls to insurance payers.

• Proficiency with Microsoft Office and ability to quickly learn new computer systems.

This is a Contract position based out of Chicago, IL.

The pay range for this position is $20.00 - $20.00/hr.

Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:
Medical, dental & vision Critical Illness, Accident, and Hospital 401(k) Retirement Plan Pre-tax and Roth post-tax contributions available Life Insurance (Voluntary Life & AD&D for the employee and dependents) Short and long-term disability Health Spending Account (HSA) Transportation benefits Employee Assistance Program Time Off/Leave…