Insurance Authorization Specialist Per Diem

1 week ago


Skokie, Illinois, United States NorthShore University HealthSystem Full time
Job Summary

As a Pre-Certification Representative I at NorthShore University HealthSystem, you will play a critical role in ensuring that our patients receive high-quality care while optimizing hospital and Medical Group revenue. Your primary responsibility will be to determine insurance eligibility and benefits, as well as pre-authorization and medical necessity requirements, for patients with various insurance plans.

Key Responsibilities
  • Verify patient selection using NorthShore protocol
  • Perform online eligibility and benefit checks for applicable payers
  • Enter data accurately into Epic in accordance with standards
  • Call insurance companies directly to obtain required eligibility and benefit information
  • Process accounts according to performance standards - timing, volume, and quality
  • Utilize established protocols to register patients and provide instructions
  • Access Medicare LMRP software to determine if an ABN is required
  • Generate and complete ABNs as needed
  • Document all activities in Epic appropriately
Requirements
  • High School diploma required
  • 1 year of experience in a contact center, healthcare environment, or customer service role
  • Experience with referrals and pre-certification strongly preferred
  • Strong attention to detail and ability to utilize multiple computer applications
  • Knowledge of medical terminology and health insurance terminology, preferred
Benefits
  • Career Pathways to Promote Professional Growth and Development
  • Various Medical, Dental, and Vision options, including Domestic Partner Coverage
  • Tuition Reimbursement
  • Free Parking at designated locations
  • Wellness Program Savings Plan
  • Health Savings Account Options
  • Retirement Options with Company Match
  • Paid Time Off and Holiday Pay
  • Community Involvement Opportunities

NorthShore University HealthSystem is a fully integrated healthcare delivery system committed to providing access to quality, vibrant, community-connected care. Our team members and physicians aim to deliver transformative patient experiences and expert care close to home across more than 300 ambulatory locations and eight acute care hospitals.



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