This position serves as a lead worker for Medical Insurance staff in the Department of Surgery. The role orients new staff, acts as a resource for staff, residents, physicians, and nurses, and is responsible for pre-authorizations and pre-certifications for patient procedures.
The specialist works closely with physicians, nurses, insurance companies, patients, and outside facilities to help ensure appropriate coverage and accurate billing for patient procedures. The position is on-site only.
Requirements & Qualifications
Qualifications
Any one or combination totaling two years of qualifying experience or education from the following:
- College coursework in a health-related field, business administration/management, human resource management, or a closely related field
- Associate's degree in one of the approved fields
- Work experience in a healthcare environment working independently with medical claims, denials, rejections, referrals, and prior authorizations
Knowledge, Skills, and Abilities
- Knowledge of customer service principles and processes
- Knowledge of English language usage, grammar, and composition
- Knowledge of medical terminology, hospital or physician billing and coding, referrals, and prior authorizations
- Knowledge of arithmetic and basic calculations
- Ability to evaluate information for compliance with standards
- Ability to use computers and computer systems effectively
- Ability to follow procedures and train others
- Ability to maintain patient confidentiality and follow HIPAA guidelines
- Ability to train others and work collaboratively
- Ability to plan, assign, and supervise the work of others
Location
Illinois, US
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
No
Posted
3 weeks ago