Registration & Insurance Specialist, Full time - Days

Be a part of a world-class academic healthcare system, UChicago Medicine, as a Registration & Insurance Specialist with the Finance Department. This is a remote, work from home opportunity, and you may be based outside of the greater Chicagoland area.

Under general direction, this position is responsible for conducting detailed reviews of patient insurance information to determine network status, verify active coverage, and review both pre- and post-billing activities for payments, including identifying self-pay balances. The role also involves initiating GAP exceptions and collaborating with managed care teams to secure single case agreements as needed. This position requires frequent communication and coordination with physicians and clinical staff involved in patient care. The ideal candidate will demonstrate strong critical thinking skills, work independently, and excel in both written and verbal communication within a fast-paced environment where timely, accurate work has a direct impact on patient care.

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Essential Functions

• Notating Epic FYI as directed within the standard work. This includes using smart phrases/smart text for easy interpretation of the note. Notes much be clear and concise for the end user to interrupt with limited abbreviations that are not well known outside of revenue cycle.
• Perform complex registration (which may require direct patient contact) and insurance reviews for out of network (OON) exceptions within the timeframes identified through department protocols. This includes correct clinical routing based on service line, verifying insurance is accurate, determining if a GAP or an SCA is a viable coverage option, reviewing account notes and billing activity to identify insurance payments and self-pay balances.
• Consistent and timely follow up with payers on the status of GAP exceptions in an effort to keep the clinical team informed for the best possible outcome.
• Coordination with key players in revenue cycle for timely follow up on OON commercial patients. This includes ensuring a proper handoff so patients are educated and informed on their plans and possible of pocket expectations. These patient may require estimates and waivers to be signed accepting financial responsibility for the course of treatment.
• Timely review of the 90/10 global period patients to ensure accuracy in the FYI notes per the standard work.
• Handle all IBCCP referrals according to the tip sheet provided. This includes proper allocation of the OTHER guarantor and insurance plan to signify IBCCP. Invoicing paperwork to be completed per standard work timely and efficiently.
• Monitor work queues and email inbox for appropriate follow up on accounts with timely resolution for end users.

Required Qualifications

• High school diploma or equivalent. 3 – 5 years of related insurance experience and 2 years of patient account experience preferably in a hospital setting. Strong communication, problem solving and organizational skills.
• Ability to work independently and as part of a team. Ability to prioritize workload and make decisions effectively and timely.
• Excellent written and oral skills
• Previous experience with hospital information systems strongly preferred.
• Proficiency in Microsoft Office Suite
• Insurance Knowledge (Basic): Understanding of health insurance types (HMO, PPO, Medicaid, Medicare).
• Coverage Verification: Ability to check eligibility, benefits, and network status.
• Familiarity with EHR/EMR Systems: Basic navigation of platforms like Epic, Cerner, or
  similar systems.
• Medical Terminology (Basic): Understanding of key insurance and billing terms.
• Data Entry: Accurate input of patient and insurance information.
• Authorization/Referral Understanding: Knowing when prior authorization or referrals may be
  needed.
• Knowledge of HIPAA: Understanding privacy regulations and how to protect patient
  information.
• Microsoft Office Proficiency: Especially Excel and Outlook for tracking and communication.

Position Details:

• Job Type/FTE: Full Time (1.0 FTE)
• Shift: Days, Monday-Friday 8am-5pm
• Unit/Department: Finance
• Work Location: Full Time Remote 
• CBA Code: Non-Union