Insurance Verification Specialist

Illinois Bone & Joint Institute, LLC (IBJI),

Founded in 1991, IBJI is the largest orthopedic group practice in Illinois. With more than 150 physicians in every orthopedic specialty, IBJI offers care for adults and children from some of the most accomplished and respected orthopedists in the country. Serving northern Illinois and northwest Indiana with over 100 locations, IBJI makes it easy to access care. Our headquarters is in Park Ridge, Illinois, a northwest suburb of Chicago. Our clinical services include advanced MRI imaging, pain management, non-surgical and surgical treatment plans, rheumatology, physical therapy, occupational therapy, wellness, and sports and sports training. Ortho Access walk-in clinics provide same day care for orthopedic injuries. Comprehensive care offered all in one place enables physicians, therapists and staff to work closely together, so that patients and families achieve better outcomes. Collaborative care is also more efficient. In many cases, IBJI services are substantially less expensive than those provided by large healthcare systems and emergency rooms.

Summary

The main focus of this position is to add to the delivery of exceptional patient-centered customer service through obtaining insurance eligibility, benefit details, and managing authorizations as required.

Responsibilities

• To execute established best practices relative to insurance requirements to maximize incoming revenue expected for services rendered
• Understand current insurance related policies, procedures and limitations
• Support front desk explaining insurance benefit and therapy costs
• Support clinical staff with timely and transparent worker's compensation approval status
• Foster relationships with physicians, administrative and clinical staff, patients, insurance representatives, and worker's compensation carrier representatives
• Communicate in a transparent and professional manner, adding to a positive work environment
• Adopt a team oriented approach, supporting the team in other concentrated areas of verification, eligibility, pre-certification/authorization as called upon by the Coordinator
• Represent IBJI core values
• Verify commercial insurance benefits within 48-72 hours in advance of the patient initial appointment
• Follow established protocols for entering the insurance benefit information or authorization status into the Rehab specific EMR
• Review eligibility dashboard daily to correct issues
• Manage pre-certification/worker's compensation authorization process and communication
• Support the front desk in patient account issue resolution
• Communicate patient benefit discrepancies or lack of coverage with the location
• Scanning, faxing, and other clerical duties
• Assist in maintaining a clean and safe work environment
• All other duties as assigned