Job Description Be part of a world-class academic healthcare system, Ingalls Memorial Hospital, as a Insurance Verifier. This position will be primarily a work from home opportunity with the requirement to come onsite as needed. You may be based outside of the greater Chicagoland area. The Insurance Verifier is under the supervision of the Patient Access leadership, initiates the process for all scheduled elective outpatient services and inpatient admissions. This includes verification for observation cases as well as add on procedures. The Insurance Verifier will be responsible for indicating if the services are financially cleared prior to the date of service. The insurance verifier will secure the necessary authorizations to support the services being ordered and in the event of an inpatient admission, they will initiate the notification of admission within the payer guidelines. They will be responsible for staying abreast of payer rules according to policy as well as state and federal billing and collection regulations. They will perform all clerical processing for completion and disposition of assigned accounts, handle patient and third-party payer inquiries as needed, makes necessary follow-up on those arrangements to ensure compliance with appropriate hospital and departmental collection policies and procedures assuring satisfactory disposition of all encounters. Essential Job Functions - Responsible for obtaining daily work list assigned to the employee to begin financial clearance process prior to the date of service for elective scheduled services and within payer guidelines for the notification of admission. Obtaining the authorization for the services rendered to ensure proper reimbursement and denial mitigation. - Handles all add-ons as assigned per work list, this includes STAT cases that need to be worked as priority per department policy - Secure all required clinical documentation needed to obtain the authorization - Maintain that all encounters needing verification is completed within 48 hours - Notify the patient as well as the ordering provider if an authorization has been delayed and work with the department to reschedule the services until the authorization of financial clearance has been obtained. - Secure all required clinical documentation needed to obtain the authorization - Maintain that all encounters needing verification is completed within 48 hours - Handling phone calls from insurance companies, doctor offices and internal departments - Staying abreast of all insurance verification rules and regulations - Stays informed of state and federal regulations in relation to hospital reimbursement, and maintains communication with personnel in HIM departments and the business office to ensure accurate reimbursement - Documents the hospital operating system with all pertinent information to support the claim if applicable. This includes the reference number of the person you spoke with at the insurance company, the name, pending authorization, clinical information for clinical documentation, etc. - Requires the ability to sufficiently understanding insurance protocols for referrals, co-payments, deductibles, allowances, etc., and analyzes information received to determine patients’ out-of-pocket liabilities - Run medical necessity as needed per payer - Collects out-of-pocket liabilities from patients upfront and applies, adjusts, and reconciles daily point- of-service cash reports - Communicates the estimated out of pocket liability for the visit. - Refers self-pay patients to Financial Counseling for self-pay screening to determine if the patient is qualified for additional financial assistance. - Refers patient accounts to financial counselors when further explanation/education is needed regarding denied authorizations, out-of-pocket liabilities, coverage options, payment plans, etc. - Performs other clerical duties as assigned by Manager, Patient Access and/or supervisor(s) - handle a variety of task with speed, and attention to detail and accuracy. Required Qualifications - High school graduate or equivalent is required. - Requires two to three years of demonstrated hospital and patient accounts experience with extensive knowledge in third party, payor/regulatory agency requirements. - Requires good analytical and problem-solving ability Preferred Qualifications - Some Medical Terminology - Requires good analytical and problem-solving ability - Excellent customer service skills - Typing required (minimum 25-30 wpm) - Experience in basic computer software programs (Microsoft Word, Excel, and Outlook) - Good written and verbal communication skills Position Details - Job Type: Full Time (1.0 FTE) - Shift :Days (Rotational) - Department: Insurance Verifier - Office Location: Ingalls Memorial Hospital- Harvey (no set days in office - on as needed basis) - CBA Code: Non-Union Why Join Us For nearly a century Ingalls Memorial has pioneered sophisticated clinical care and developed the area's most convenient network of comprehensive outpatient centers, all dedicated to improving the health and wellbeing of the community. Now, partnered with UChicago Medicine, we have expanded our network of expert physicians, convenient facilities and scope of service to speed your healing process and help navigate your path to wellness. A skilled Medical Staff and talented employees dedicated to prevention, diagnosis, treatment and rehabilitation of illness and injury provide a firm foundation for our reputation for quality. To accomplish this, we need employees with passion, talent and commitment… with patients and with each other. We’re in this together: working to advance medical innovation, serve the health needs of the community, and move our collective knowledge forward. If you’d like to add enriching human life to your profile, UChicago Medicine Ingalls Memorial is for you. Here at Ingalls, we’re doing work that really matters. Join us! UChicago Medicine Ingalls Memorial is growing; discover how you can be a part of this pursuit of excellence at: Ingalls Career Opportunities UChicago Medicine Ingalls is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, ethnicity, ancestry, sex, sexual orientation, gender identity, marital status, civil union status, parental status, religion, national origin, age, disability, veteran status and other legally protected characteristics. As a condition of employment, all employees are required to complete a pre-employment physical, background check, drug screening, and comply with the flu vaccination requirements prior to hire. Medical and religious exemptions will be considered for flu vaccination consistent with applicable law. Compensation & Benefits Overview UChicago Medicine is committed to transparency in compensation and benefits. The pay range provided reflects the anticipated wage or salary reasonably expected to be offered for the position. The pay range is based on a full-time equivalent (1.0 FTE) and is reflective of current market data, reviewed on an annual basis. Compensation offered at the time of hire will vary based on candidate qualifications and experience and organizational considerations, such as internal equity. Pay ranges for employees subject to Collective Bargaining Agreements are negotiated by the medical center and their respective union. Review the full complement of benefit options for eligible roles at Benefits - UChicago Medicine.

• Investigating, evaluating, and resolving low to moderately complex auto claims • Managing the end-to-end claims process, including repairable and total loss claims • Identifying recovery opportunities when appropriate • Partnering with customers, vendors, and internal teams to deliver fair, efficient outcomes

• Investigate, evaluate, negotiate and adjust moderate to high complexity claims presented by or against our insureds • Confirm coverage, determine legal liability and equitably settle/defend in compliance with all state regulatory requirements • Manage and support the customer through the damages process for both repairable and total loss claims • Look for recovery opportunities and pursue them when appropriate • Provide claims service via various channels to policy holders and third-party customers • Acquire and apply advanced knowledge of Property & Casualty insurance industry products, services, and processes • Seek guidance from team members to resolve issues and identify appropriate issues for escalation • Partner with and/or directs vendors and internal business partners to facilitate claims resolution • Contribute to business goals, performance metrics, and effectively use tools & technology • Support workload surges and/or catastrophe operations as needed

Join VitalCaring – Where Your Passion Changes Lives! Are you looking for a career where compassion meets purpose? At VitalCaring, we’re more than a home health and hospice provider—we’re a family that supports, inspires, and uplifts both our patients and our team members. Who We Are Founded in 2021, VitalCaring has grown into a leading provider of home health and hospice services, with over 65 locations across the country. We are committed to fostering a culture of support, growth, and excellence for our team that is the backbone of how we ensure we deliver exceptional patient care. Why Choose VitalCaring? Work That Fits Your Life – Discover the ideal balance of purpose and flexibility. As a full-time salaried clinician, you’ll enjoy the stability of a consistent role with the freedom to manage personal commitments throughout your day. Our field team thrives in an environment that empowers them to make a real impact—while still having the time and space to prioritize what matters most at home. With a generous 6 weeks of paid time off each year, you’ll have the opportunity to recharge, reconnect, and return ready to do your best work. Make a Meaningful Impact – Help patients and families navigate their healthcare journey with compassion and dignity. Thrive in a Supportive Team – Work with a team who genuinely care and invest in your success. Grow Your Career – Take advantage of advanced training, mentorship, and career development opportunities. Competitive Pay & Benefits – Receive a rewarding compensation package that recognizes your dedication and expertise. Our benefits are designed to empower you with the resources, flexibility, and security needed to thrive both professionally and personally. This is a remote position eligible to those who reside in Alabama, Mississippi, Texas, Louisiana, Oklahoma, or Florida Health & Wellness Medical, Dental & Vision Pharmacy Benefits Virtual & Mental Health Support Flexible Spending Accounts (FSAs) & Health Savings Account (HSA) Supplemental Health & Life Insurance Financial & Legal 401(k) with Company Match Employee Referral Program Prepaid Legal Plans Identity Theft Protection Work-Life Balance & Perks Paid Time Off Pet Insurance Tuition & Continuing Education Reimbursement As the Insurance Verification and Authorization Specialist, you will: - Conduct insurance verification through payer portals, phone calls, and HCHB’s integrated tools for all new referrals and ongoing patients. - Initiate and obtain prior authorizations for home health services including nursing, therapy, and aide services as required by payers. - Accurately enter and maintain insurance, authorization, and eligibility information within the HCHB system in real-time. - Review patient intake information to ensure payer requirements are identified and addressed early in the admission process. - Collaborate with intake, clinical staff, case managers, and billing teams to resolve authorization-related issues promptly - Follow up proactively with insurance companies to ensure timely processing of authorizations and appeals. - Stay current on payer-specific authorization protocols, documentation requirements, and changes to coverage policies affecting home health. - Ensure compliance with HIPAA, Medicare Conditions of Participation, and other regulatory standards. - Maintain organized and auditable records of all insurance and authorization communications and decisions within HCHB and agency systems Skills for Success: - Fully remote during agency operating hours - Ideal candidate should reside in Texas, Louisiana, Mississippi, Florida, or Alabama - Regular use of computers, phones, and HCHB software system. - Requires flexibility and the ability to adapt to frequent changes in payer rules and agency workflows. - Work deals mostly with areas such as preparing and reading data and figures, records, reports, visual inspection involving small details. Although important, depth perception and field of vision (peripheral) are not as critical as the ability to distinguish small details and markings very near to the observer. - Requires ability to concentrate on fine detail with frequent interruption; ability to focus attention on tasks for 10-20 minutes at a time on a continuous basis, 20-60 minutes on occasion. - Requires the ability to remain calm and courteous under stress. - Requires working under strict turnaround time guidelines to meet business needs. - Requires ability to communicate clearly and make self-understood effectively in face-to-face interactions; articulate with accuracy to communicate using phone. - Requires ability to hear and receive verbal instructions correctly, answer phones, communicate professionally in situations with some background noise. - Requires ability to understand and relate to specific ideas one at a time and to the concepts behind specific ideas; ability to remember verbal and written tasks/assignments from a few hours to several day periods. - Excellent computer software skills necessary to produce accurate documents and materials required. - Working knowledge of MS Office, Excel or similar software required. Proficient knowledge preferred. - Requires ability to work effectively under minimal supervision; exercise excellent, sound professional judgment and maintain confidentiality. - Must have and maintain valid Driver’s License, and proof of current valid auto liability insurance. Experience to Deliver on our Mission: - High school diploma or equivalent required; associate degree or higher preferred. - Minimum 2 years of experience in home health authorization/eligibility processes. - Proficiency in Homecare Homebase (HCHB) strongly preferred. - Strong understanding of traditional Medicare, Medicare Advantage, and commercial insurance guidelines. - Experience navigating payer websites/portals (e.g., Availity, Waystar, Palmetto etc.). - Detail-oriented with excellent organizational and follow-up skills. - Effective communication and customer service skills with both internal teams and external payers. - Ability to multitask in a high-volume, fast-paced remote or office environment. Come home to VitalCaring where you will find your passion, find your people, and find yourself again. Together we can transform lives and foster hope through genuine caring. Explore your future with VitalCaring today.