Insurance Verification Representative Day Shift Marianjoy

Insurance Verification Representative Full Time Day Shift Marianjoy

Join to apply for the Insurance Verification Representative Full Time Day Shift Marianjoy role at Northwestern Medicine Central DuPage Hospital

The salary range for this position is $22.61 - $29.39 (Hourly Rate). Placement within the salary range is dependent on several factors such as relevant work experience and internal equity. For positions represented by a labor union, placement within the salary range is guided by the rules outlined in the collective bargaining agreement.

We offer a wide range of benefits that provide employees with tools and resources to improve their physical, emotional, and financial well‑being while providing protection for unexpected life events. Please visit our Benefits section located .org/benefits to learn more.

• $10,000 Tuition Reimbursement per year ($5,700 part‑time)
• $10,000 Student Loan Repayment ($5,000 part‑time)
• $1,000 Professional Development per year ($500 part‑time)
• $250 Wellbeing Fund per year ($125 for part‑time)
• Matching 401(k)
• Excellent medical, dental and vision coverage
• Life insurance
• Annual Employee Salary Increase and Incentive Bonus
• Paid time off and Holiday pay

• Obtains and coordinates preliminary case management authorization.
• Coordinates information from the patient, physicians and office staff, clinical referral liaisons and employers as needed to complete the verification process.
• Obtains third‑party pre‑certification and concurrent review information and communicates to admissions staff, clinical referral liaisons, case managers, appropriate physician departments and payer representatives.
• Communicates any changes in patient's clinical status to third‑party payer to ensure authorization is current and accurate and provides notice of patient admission into the facility.
• Keeps insurance verification tracking log current and available to admissions staff and clinical referral liaisons with the most up‑to‑date status of patients in the verification queue.
• Communicates situations projected to result in a significant non‑covered balance to the department director.
• Communicates corrected information and acts as a resource to admissions staff, clinical referral liaisons, case managers and others regarding contract guidelines and pre‑certification requirements.
• Notifies admissions staff, clinical referral liaisons and department director when medical review is required.
• Reviews and analyzes financial information from third‑party payer systems and communicates that information to the business office and appropriate servicing department.
• Keeps up‑to‑date on trends and issues that affect reimbursement.
• Performs verification/certification function using alternative processes in case of downtime or disaster.
• Tracks and records insurance denial trends, and manages the appeal process on behalf of patients.

• High School or Equivalent (GED)
• Knowledge of medical, insurance terminology, and ICD codes is required.
• Ability to understand and communicate financial information.
• Highly proficient computer skills preferred.
• Ability to work independently.
• Excellent communication skills are required.
• Strong customer service focus is essential.
• Resourceful with problem solving.
• Well organized and efficient.
• Required to demonstrate proper telephone customer skills.
• Must be able to perform multiple tasks with composure and confidence.
• Ability to maintain composure under pressure.

• Three to four years of health‑related experience
• Associate or Bachelors Degree

Northwestern Medicine is an affirmative action/equal opportunity employer and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation or any other protected status. If we offer you a job, we will perform a background check that includes a review of any criminal convictions. A conviction does not disqualify you from employment at Northwestern Medicine.

We consider this on a case‑by‑case basis and follow all state and federal guidelines.