Remote - Insurance Clearance Rep Senior

Advocate Aurora Health

Base: $22.90 - $34.35; bonus/equity: not specified...
Acquire payor requirements knowledge
Perform insurance authorizations
Analyze clinical data for authorization
Acquires and maintains current knowledge of all payor requirements as it relates to patient/hospital responsibility for authorizations and hospital billing, including all Federal and State regulations

Job Summary

  • Acquires and maintains current knowledge of all payor requirements as it relates to patient/hospital responsibility for authorizations and hospital billing, including all Federal and State regulations.
  • Performs all insurance authorization of inpatient and outpatient services, by accurately collecting and analyzing clinical data in support of payor guidelines and submits accordingly.
  • Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work.

Matching Summary

Acquires and maintains current knowledge of all payor requirements as it relates to patient/hospital responsibility for authorizations and hospital billing, including all Federal and State regulations.

Salary

Base: $22.90 - $34.35; Bonus/Equity: Not specified; Benefits: Paid Time Off programs, Health and welfare benefits, Flexible Spending Accounts, Family benefits, Defined contribution retirement plans, Educational Assistance Program

Skills & Requirements

Must-have

  • Acquire payor requirements knowledge
  • Perform insurance authorizations
  • Analyze clinical data for authorization
  • Determine appropriate procedure codes
  • Consult on uninsured/out-of-network status
  • Communicate financial responsibility to patients
  • Maintain computer software knowledge
  • Ensure PCP identification for HMO
  • Identify at-risk Medicaid balances
  • Complete cancellations and reschedules
  • Manage patient calls for pre-registration
  • Accurate demographic and insurance entry
  • Generate and process required documents
  • Participate in staff meetings
  • Maintain patient record confidentiality
  • Problem solve in high stress area
  • Prioritize and organize workload
  • Mathematical aptitude
  • Effective communication skills
  • Critical thinking skills
  • Understanding of human anatomy
  • Understanding of medical terminology
  • Excellent verbal and written communication
  • General computer knowledge

Nice-to-have

  • Seek out education opportunities
  • Actively participate in group projects
  • Operational knowledge of departments

Key Requirements

  • High School Graduate
  • 2 years of experience in health care, insurance industry, call center, or customer service setting

Work Rights

Not specified

Tailored Resume

Cover Letter