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Insurance Verification Associate Jobs in Illinois

Quantix SCS LLC

Rail Car Verifier

Streator, IL · On-site

Timely Team Rail Car verification with Drivers and assisting in load hook up / break down and all ... Responsible for taking direction from Supervisor and or Lead associate. * Responsible for any other ...

Gerald Gresham & Associates

Insurance Sales

Shorewood, IL · On-site

$52K - $71K/yr

Gerald Gresham & Associates in Shorewood, Illinois, is looking for a talented and driven individual ... Verify phone numbers, and email addresses with each customer contact and update customer ...

Dermatology Associates

Be Seen First

Front Desk Coordinator

Tinley Park, IL · On-site

$20 - $22/hr

Verify patient demographics, insurance information, and required documentation * Schedule patient ... Supportive and team-oriented work environment Company Description Dermatology Associates is a group ...

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Insurance Verification Associate information

What are the key skills and qualifications needed to thrive as an Insurance Verification Associate, and why are they important?

To thrive as an Insurance Verification Associate, you need strong attention to detail, knowledge of insurance policies and procedures, and typically a high school diploma or equivalent. Familiarity with insurance verification software, electronic health records (EHR) systems, and claims management tools is highly valuable. Excellent communication, problem-solving skills, and the ability to handle confidential information with discretion set top performers apart. These skills ensure accurate processing of patient insurance information, minimize billing errors, and support timely reimbursement for healthcare services.

What are some common challenges faced by Insurance Verification Associates, and how can they be overcome?

Insurance Verification Associates often encounter challenges such as navigating complex insurance policies, handling discrepancies in patient information, and managing high call volumes with insurance companies. To overcome these, associates should develop strong attention to detail, effective communication skills, and proficiency with insurance databases and electronic health record systems. Staying organized and keeping up-to-date with insurance policy changes also helps ensure accurate and timely verification, which ultimately supports smooth patient billing and care processes.

What does an Insurance Verification Associate do?

An Insurance Verification Associate is responsible for confirming a patient's insurance coverage and benefits before medical services are provided. Their tasks include contacting insurance companies, verifying policy details, determining coverage limits, and ensuring that procedures are authorized. This role helps prevent billing issues and ensures that patients and providers understand what costs will be covered. Insurance Verification Associates play a crucial part in the healthcare revenue cycle by reducing claim denials and improving the patient experience.

What is the difference between Insurance Verification Associate vs Medical Billing Specialist?

AspectInsurance Verification AssociateMedical Billing Specialist
Primary RoleVerify patient insurance coverage and benefits before servicesProcess and submit medical claims for reimbursement
CredentialsHigh school diploma or equivalent; certifications like Certified Medical Administrative Assistant (CMAA) are commonHigh school diploma; certifications like Certified Professional Biller (CPB) are common
Work EnvironmentHealthcare offices, hospitals, clinicsMedical offices, billing companies, healthcare facilities
Industry UsageUsed across healthcare providers to ensure insurance coverageUsed to handle claims processing and reimbursement

The Insurance Verification Associate focuses on confirming patient insurance details to ensure coverage before treatment, while the Medical Billing Specialist handles the claims process for reimbursement. Both roles require similar certifications and work in healthcare settings, but their core responsibilities differ in the patient verification versus billing process.

What are the most commonly searched types of Insurance Verification jobs in Illinois? The most popular types of Insurance Verification jobs in Illinois are:
What cities in Illinois are hiring for Insurance Verification Associate jobs? Cities in Illinois with the most Insurance Verification Associate job openings:
Insurance Verification Associate jobs near you
Pharmacy Benefit Verification Specialist

Pharmacy Benefit Verification Specialist

CareMed Specialty Pharmacy

Woodridge, IL

$24/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 2 days ago

Job description

Are you someone looking for professional career growth? CareMed Pharmacy is looking for Pharmacy Benefit Verification Specialists for our growing Pharmacy!
Work Hours: Monday-Friday shifts available; some weekends as needed.
**Starting salary at $24.00/hr and up** We also offer quarterly incentive bonuses.
Sign-On Bonus: $5,000 for employees starting before July 31, 2026.
We offer a variety of benefits including:
  • Medical, Dental amp; Vision insurance
  • 401k with a match
  • Paid Time Off and Paid Holidays
  • Tuition Reimbursement
  • Paid Volunteer Day
  • Floating Holiday
  • Referral Incentive
  • Paid Life, and short amp; long-term disability insurance
Pharmacy Benefit Verification Specialist Summary:
The Benefit Verification Specialist will investigate, review, and load accurate patient insurances, including medical and pharmacy coverage, assign coordination of benefits, run test claims to obtain a valid insurance response on patient medications, investigate/identify authorization requirements needed to obtain medication coverage, and enroll eligible patients in copay card assistance programs. They will ensure accurate benefit documentation is made for all prescription orders.
Pharmacy Benefit Verification Specialist Major Responsibilities:
  • Practices first call resolution to help health care providers and patients with their pharmacy needs, answering questions and requests.
  • Provides thorough, accurate and timely responses to requests from pharmacy operations, providers and/or patients regarding benefit information.
  • Ensures complete and accurate patient setup in CPR+ system including patient demographic and insurance information.
  • Performs full benefits verification on patients for pharmacy benefits and/or medical benefit utilizing electronic resources and E1 check to load primary, secondary, tertiary, etc. insurances and medical insurances to patient profile.
  • Run test claims at each licensed pharmacy site to obtain a valid claim response and determine optimal reimbursement, then document outcome of benefits review in CPR+ system to be used by operations and ensure the order is assigned to the appropriate dispensing pharmacy.
  • Facilitate process for requesting medical authorizations, LOAs, and TOAs for applicable commercial, Medicaid, and Medicare, or facility medication claims.
  • Maintain a safe and clean pharmacy by complying with procedures, rules, and regulations and compliance with professional practice and patient confidentiality laws
  • Contributes to team effort by accomplishing related tasks as needed and other duties as assigned.
  • Conducts job responsibilities in accordance with the standards set out in the Company’s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.
Pharmacy Benefit Verification Specialist Qualifications:
  • Education/Learning Experience
    • Required: High School Diploma or GED. Previous Experience in Pharmacy, Medical Billing, or Benefits Verification
    • Desired: Associate degree or equivalent program from a 2 year program or technical school, Certified Pharmacy Technician (PTCB), Specialty pharmacy experience
  • Work Experience
    • Required: 1+ years pharmacy or benefit verification experience
    • Desired: 3+ years pharmacy or benefit verification experience
  • Skills/Knowledge:
    • Required: Pharmacy insurance and benefit verification, PBM and Medical contracts, knowledge/understanding of Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, pharmacy or healthcare-related knowledge, knowledge of pharmacy terminology including sig codes, and Roman numerals, brand/generic names of medication, basic math and analytical skills, Intermediate typing/keyboarding skills.
  • Behavior Competencies
    • Required: Independent worker, good interpersonal skills, excellent verbal and written communications skills, ability to work independently, work efficiently to meet deadlines and be flexible, detail-oriented, great time-management skill
Here at CareMed, our patients are important to us, so we always strive to meet and exceed their needs. We are seeking Pharmacy Benefit Verification Specialists who go above and beyond for our patients, and also passionate about helping others.

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