Insurance Verification Representative I - Inpatient Rehab - Days

Company: Endeavor Health
Location: Arlington Heights
Posted on: February 25, 2026

Job Description:

Hourly Pay Range: $19.89 - $28.84 - The hourly pay rate offered is determined by a candidate's expertise and years of experience, among other factors. Position Highlights: - Position: Insurance Verification Representative I - Location: Northwest Community Hospital, Arlington Heights, IL - Full Time/Part Time: part-time - 32 hours per week - Hours: Monday, Thursday, Friday 7:30-4 (hours flexible). Tuesday, Wednesday 8-12:00 - Required Travel: no A Brief Overview: The Insurance Verification Representative will be under the management of the Manager, Patient Access, the Pre-Certification Representative I is responsible to determine insurance eligibility and, as appropriate benefits, pre-authorization / pre-certification and medical necessity requirements based on patient specific insurance. The Pre-Certification Representative I provide this service to ensure that our customers are provided a high-quality experience which includes understanding of patient responsibility and ease of access to clinical services. This is achieved through coordination with and education of the patient. The Pre-Certification Representative I help to ensure that patient satisfaction and loyalty are achieved while hospital and Medical Group revenue is optimized. What you will do: - Use Endeavor Health protocol to verify patient selection. - Performs online eligibility and benefit checks for applicable payers as outlined in guidelines. - Enters data accurately into Epic in accordance with standards. - Calls the insurance company directly to obtain required eligibility and benefit information for all managed care, governmental and commercial payers, - Verifies if pre-certification is required. - Process accounts according to performance standards - timing, volume and quality - Use NorthShore protocol to verify patient selection. - Utilize established protocols to register patient (e.g. select insurance and guarantor, verify/enter demographic information) - Provide instructions to patient (e.g. prep instructions related to procedure, location, co-pay) - Accesses Medicare LMRP software to determine if ABN (Advance Beneficiary Notice) is required. - Ascertain medical necessity requirements for visit utilizing NEBO Eligibility Software. - If medical necessity check fails, contact physician for more appropriate diagnosis if available. - Generate and complete ABN when needed and contacted the ordering physician and patient as outlined in procedural guidelines to communicate and explain requirement. - For pre-registered patients, fax the ABN to the responsible check-in area (department or registration) for the service. - Document all activities in Epic appropriately. - Process accounts according to performance standards - timing, volume and quality - Contacts physician office or insurance company to check status of and / or obtain existing precertification number for ordered service. - Documents obtained information including certification number and number of days approved for inpatients into Epic. - If authorization is not obtained as required, contact physician office and department regarding cancellation of procedure. - If authorization is not obtained due to medical necessity, contact ordering physician's office and patient regarding waiver requirement. - Generate and forward waiver as needed to department for patient signature. - Follows standards for documenting cases and forwarding to Financial Counseling. - Identify if callers have an existing NorthShorConnect account. - If not, introduce NorthShoreConnect and encourage patient use. - Utilize Epic to create NorthShoreConnect account for patients. - Apply HIPAA guidelines to all situations, as appropriate. - Follow all NorthShore protocols to ensure compliance with HIPAA. - What you will need: - High School Required - 1 Year of experience in a contact center, healthcare environment or customer service role. And - Experience with referrals and pre-certification strongly preferred. - Basic math skills - Basic computer skills - Typing speed of 30 wpm - Demonstrated record of excellent customer service skills - Strong verbal communication skills: ability to speak clearly and articulate to customers and co-workers. - Strong written communication skills to record patient activity in Epic. - Strong active listening skills to effectively assist multiple customer types and identify ""panic"" or ""hot"" words. - Ability to display empathy when dealing with customers. - Critical thinking skills - Decision-making and problem-solving skills - Strong attention to detail to accurately enter data and research and resolve questions - Ability to work independently with minimal supervision. - Ability to multi-task - Ability to utilize multiple computer applications and operating system concurrently. - Ability to recognize customers' anger and attempt to defuse it. - Knowledge of medical terminology and health insurance terminology, preferred. - Front desk/central scheduling and/or registration experience, preferred. - Epic experience, preferred Benefits: - Career Pathways to Promote Professional Growth and Development - Various Medical, Dental, and Vision options - Tuition Reimbursement - Free Parking at designated locations - Wellness Program Savings Plan - Health Savings Account Options - Retirement Options with Company Match - Paid Time Off - Community Involvement Opportunities

Keywords: Endeavor Health, Wauwatosa , Insurance Verification Representative I - Inpatient Rehab - Days, Healthcare , Arlington Heights, Wisconsin