Advocate Health Care · 1 day ago
Insurance Clearance Representative
Oak Brook, IL
Full-time
Onsite
Entry Level
$21/hr - $32/hr
1+ years expAdvocate Health Care is seeking an Insurance Clearance Representative to manage insurance authorizations for inpatient and outpatient services. The role involves consulting with patients regarding their insurance status and ensuring compliance with payor guidelines while maintaining accurate patient information.
Clinical TrialsDeliveryHealth Care
Responsibilities
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
Uses resources to determine appropriate procedure codes for authorization to ensure appropriate reimbursement
Consults with patient and appropriate departments for uninsured status, uncovered services, out of network status and situations where the only insurance is Third Party Liability or Workers Compensation and provides next steps
Initiates communication to the patient when authorization is not obtained and explains the potential financial responsibility
Maintains knowledge of all stand-alone computer software programs to verify eligibility and authorization
Ensures completion of all established policies and procedures for identification and notification of the Primary Care Physician in the case of HMO coverage
Identifies at risk balances related to Medicaid eligibility rules and communicates to Financial Counseling, Utilization Management, and physicians
Manages incoming and outgoing calls to complete pre-registration with patients
Pre-registers and registers patients using established procedures for computer entry for all ancillary and nursing units, keeping current with the specialized needs, and preparing necessary documents/records when necessary
Ensures accurate entry of patient demographic and insurance information in the ADT system with special attention to carrier code assignment, complete benefit, eligibility record and authorization data
Generates and processes all required documents for completion of registration, providing detailed education to the patient on the documents and forms requiring patient signature
Participates in department staff meetings and keeps abreast of continuing education to ensure effective communication and to maintain skill competency
Seeks out education opportunities to increase knowledge in department procedures as it relates specifically to scheduling needs for that area
Attends all mandatory in-services 100% and completes all mandatory safety in-services and skill competencies as required
Actively participates in group projects to problem solve department issues
Operational knowledge of the various Advocate Aurora Health departments so that patient, visitor, and fellow employee questions are answered or referred in an appropriate manner
Maintains confidentiality of patients records by following HIPAA and all compliance policies and guidelines
Qualification
Required
High School Graduate
Typically requires 1 year of experience in health care, insurance industry, call center or customer service setting
Ability to problem solve in a high profile and high stress area
Ability to prioritize and organize workload
Mathematical aptitude, effective communication, and critical thinking skills
Understanding of basic human anatomy and medical terminology
Excellent verbal and written communication skills
General computer knowledge
Must be able to sit most of the workday
May include intermittent light travel
Operates all equipment necessary to perform the job
Company
Advocate Health Care
Advocate Health Care is an integrated healthcare delivery system based in Illinois, United States.
10001+ employees
H1B Sponsorship
Advocate Health Care 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 (26)
2024 (9)
2023 (6)
2022 (16)
2021 (8)
2020 (7)
Funding
Current Stage
Late StageTotal Funding
$18M2013-10-03Series Unknown· $18M
Leadership Team
Barbara Hancock
Executive Assistant to the President and Chief Operating Officer
David Rich
Clinical Practice Partner
Recent News
2025-10-10
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2025-10-01
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