Insurance Representative II

Position: Insurance Rep II

Location: Warrenville, IL

Full Time

Hours: Monday-Friday, [hours and flexible work schedules]

Review and process insurance claims for accuracy, completeness, and compliance with relevant insurance policies and healthcare regulations.

Monitor and follow up on pending insurance claims, including appeals and resubmissions, to expedite reimbursement and minimize claim denials.

Verify patient insurance coverage, including policy details, eligibility, and benefit information, to ensure accurate claim submissions.

Investigate and resolve claim denials and disputes, providing necessary documentation and communication with insurance companies for claim approval.

Assist patients in understanding their insurance claims, explaining coverage and reimbursement processes, and addressing any questions or concerns.

Provide support to patients in understanding and managing their healthcare expenses, including explaining payment options, financial assistance programs, and payment plans.

Maintain accurate and detailed records of all interactions, claim processing, and patient communications, ensuring compliance with hospital standards and regulatory requirements.

Stay updated on changes in insurance regulations, ensuring that claim processes align with legal and compliance standards, including HIPAA.

Generate reports and maintain metrics related to insurance claim status, reimbursement rates, and resolution times.

Gather and document patient feedback and suggestions, reporting relevant trends or issues to the appropriate department for process improvement.