Insurance Verification Rep

From primary to specialty care, as well as walk-in and virtual services, CHI Health Clinic delivers more options and better access so you can spend time on what matters: being healthy. We offer more than 20 specialties and 100 convenient locations; with some clinics offering extended hours.

As an Insurance Verification Representative, you will provide critical pre-service support and meticulous verification of patient insurance benefits, ensuring financial clarity and a smooth patient experience.

Every day you will expertly contact insurance payers, confirm coverage details, identify patient responsibilities, and meticulously document all findings to facilitate accurate billing and address potential financial barriers to care.

To be successful, you will demonstrate outstanding attention to detail, strong communication skills, and a persistent, customer-focused demeanor, contributing significantly to revenue integrity and informed patient access.

• Applies a thorough understanding/interpretation of Verification of Benefits (VOB) to, confirm patient eligibility
• Communicates effectively over the phone and through written correspondence with providers, clinical staff, clinic managers, and payers to obtain VOB, and behavioral authorizations.
• Applies understanding and knowledge of medical terminology, payer guidelines, CPT codes, ICD-10 codes to ensure appropriate behavioral authorizations are obtained
• Recognizes when additional assistance is needed to resolve complex issues and escalates appropriately and timely through defined communication and escalation channels.
• Resolves work queues according to the prescribed priority and/or per the direction of management and in accordance with policies, procedures and other job aides.
• Works the claim edit work queues timely and efficiently to correctly resolve the error.

Required

• Local candidates will need to train 6 months in office before going remote