Northwestern Medicine · 2 weeks ago
Insurance Verification Representative Full Time Day Shift Marianjoy
Wheaton, IL
Full-time
Onsite
Mid Level
3+ years expNorthwestern Medicine is a leader in the healthcare industry focused on patient-first interactions. The Insurance Verification Representative is responsible for verifying insurance benefits, obtaining necessary authorizations, and communicating with various stakeholders to ensure accurate patient financial information is maintained.
Emergency MedicineHealth CareHospitalMedicalNutritionRehabilitation
Responsibilities
Obtains and coordinates preliminary case management authorization
Coordinates information from the patient, physicians and office staff, clinical referral liaisons and employers as needed to and complete the verification process
Obtains third-party pre-certification and concurrent review information and communicates to the admissions staff, clinical referral liaisons, case managers, appropriate physician departments and payer representatives
Communicates any changes in patient's clinical status to third-party payer to ensure authorization is current and accurate and provides notice of patient admission into the facility
Keeps insurance verification tracking log current and available to admissions staff and clinical referral liaisons with the most up-to-date status of patients in the verification queue
Communicates situations projected to result in a significant non-covered balance to the department director
Communicates corrected information and acts as a resource to admissions staff, clinical referral liaisons, case managers and others regarding contract guidelines and pre-certification requirements
Notifies admissions staff, clinical referral liaisons and department director when medical review is required
Reviews and analyzes financial information from third party payer systems and communicates that information to the business office and appropriate servicing department
Keeps up-to-date on trends and issues that affect reimbursement
Performs verification/certification function using alternative processes in case of downtime or disaster
Tracks and records insurance denial trends, and manages the appeal process on behalf of patients
Collects accurate financial data and enters into Meditech
Works with admissions staff, clinical referral liaisons, case managers and other departments ensuring financial data integrity is maintained and critical elements are reflected in the patient record
Maintains a strong customer focus while working collaboratively within a team to meet multiple demands, patient needs and coverage
Maintains confidentiality of all information
Suggests quality improvement ideas and participates in education and improvement efforts
Provides communication to patients, patient financial services, and case managers on insurance findings
Contacts patients, guarantor and business offices to inform of financial responsibility and attempts to coordinate financial arrangement
Produces projected benefit letters for patients and acts as a point person for counseling
Communicates benefit detail to admissions staff, clinical referral liaisons and case managers to ensure notification and collection of co-pays, deductibles and outstanding balances
Coordinates additional information requests as may be necessitated by third party administrators
Qualification
Required
High School or Equivalent (GED)
Knowledge of medical, insurance terminology, and ICD codes is required
Ability to understand and communicate financial information
Highly proficient computer skills preferred
Ability to work independently
Excellent communication skills are required
Strong customer service focus is essential
Resourceful with problem solving
Well organized and efficient
Required to demonstrate proper telephone customer skills
Must be able to perform multiple tasks with composure and confidence
Ability to maintain composure under pressure
Preferred
Three to four years of health-related experience
Associate or Bachelors Degree
Benefits
Tuition reimbursement
Loan forgiveness
401(k) matching
Lifecycle benefits
Company
Northwestern Medicine
Northwestern Medicine is the collaboration between Northwestern Memorial HealthCare and Northwestern University Feinberg School of Medicine around a strategic vision to transform the future of health care.
10001+ employees
H1B Sponsorship
Northwestern Medicine has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (75)
2024 (66)
2023 (70)
2022 (78)
2021 (35)
2020 (39)
Funding
Current Stage
Late StageTotal Funding
$25M2018-06-26Grant· $25M
Leadership Team
Howard Chrisman, MD
President and CEO
John A. Orsini, CPA
Senior Vice President and Chief Financial Officer
Recent News
Near North Health
2025-12-01
Medical Xpress - latest medical and health news stories
2025-11-18
Company data provided by crunchbase