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Weekday Insurance Utilization Review Jobs in Illinois

Insurance Verifier

Chicago, IL · On-site

$22.29 - $26.74/hr

... Utilization Review • Nursing Units • Patient Financial Services • Provide timely updates ... Requirements This position requires a rotating schedule, including rotating weekdays, weekends, and ...

We are the largest insurance company in South Carolina ... and much more. We are one of the nation ... Responsible for the supervision and maintenance of the daily functions of Utilization Review/Review ...

New

We are the largest insurance company in South Carolina ... and much more. We are one of the nation ... Responsible for the supervision and maintenance of the daily functions of Utilization Review/Review ...

New

We are the largest insurance company in South Carolina ... and much more. We are one of the nation ... Responsible for the supervision and maintenance of the daily functions of Utilization Review/Review ...

New

We are the largest insurance company in South Carolina ... and much more. We are one of the nation ... Responsible for the supervision and maintenance of the daily functions of Utilization Review/Review ...

New

... utilization management experience preferred. • Knowledge of Medicare/Medicaid, Managed Care and Commercial insurance review processes preferred. • Ability to proactively anticipate and coordinate ...

RN Case Manager

Mattoon, IL · On-site

$1.9K - $2.0K/wk

Case Management/Utilization Review Shift: Day Shift Details: null Day Job Type: Travel Benefits: * Day 1 Insurance * Cigna medical, MetLife dental and vision insurance * License reimbursement for new ...

RN - Case Manager

Mattoon, IL · On-site

$1.9K - $2.0K/wk

Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Mattoon ... Benefits: * Day 1 Insurance * Cigna medical, MetLife dental and vision insurance * License ...

MANAGER CASE MANAGEMENT

Morris, IL · On-site

$19.50 - $25/hr

Two years previous experience in case management/utilization review. * Certification in Case ... vesting - Life insurance - Disability coverage - Nurse residency program - Wellness program ...

MANAGER CASE MANAGEMENT

Morris, IL

$19.50 - $25/hr

Two years previous experience in case management/utilization review. * Certification in Case ... vesting - Life insurance - Disability coverage - Nurse residency program - Wellness program ...

MANAGER CASE MANAGEMENT

Morris, IL · On-site

$93K - $140K/yr

Two years previous experience in case management/utilization review. * Certification in Case ... vesting - Life insurance - Disability coverage - Nurse residency program - Wellness program ...

... for utilization review. MD (or equivalent) level training is required but current Board ... Please be aware that initial training is conducted during the weekday (M-F). Qualifications: · ...

Travel Case Manager RN

Mattoon, IL · On-site

$1.9K - $2.0K/wk

Travel Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Mattoon ... Benefits: * Day 1 Insurance * Cigna medical, MetLife dental and vision insurance * License ...

Revenue Cycle (Case Management, Utilization Review, CDI, Care Coordination) * Materials Management ... Reviews and approves financial terms of contracts, including MCOs, insurance agreements, vendor ...

Revenue Cycle (Case Management, Utilization Review, CDI, Care Coordination) * Materials Management ... Reviews and approves financial terms of contracts, including MCOs, insurance agreements, vendor ...

Showing results 41-60

Weekday Insurance Utilization Review information

What is the difference between Weekday Insurance Utilization Review vs Weekday Claims Processor?

AspectWeekday Insurance Utilization ReviewWeekday Claims Processor
Primary RoleAssessing medical necessity and appropriateness of servicesProcessing and reviewing insurance claims for payment
CredentialsOften requires healthcare or insurance certificationsTypically requires insurance or administrative experience
Work EnvironmentHealthcare settings, insurance companiesInsurance companies, healthcare offices
FocusMedical review and authorizationClaims data entry and verification

Weekday Insurance Utilization Review focuses on evaluating medical necessity, while Weekday Claims Processors handle the administrative processing of insurance claims. Both roles are essential in the insurance industry but serve different functions related to claims management and healthcare authorization.

What are the most commonly searched types of Insurance Utilization Review jobs in Illinois?

The most popular types of Insurance Utilization Review jobs in Illinois are:

What cities in Illinois are hiring for Weekday Insurance Utilization Review jobs?

Cities in Illinois with the most Weekday Insurance Utilization Review job openings:

$22.29 - $26.74/hr

Full-time

Medical, Dental, Vision, Retirement

Re-posted 26 days ago


Job description

Position Title: Insurance Verifier
Full-time - 6a-230p
Day Shift
Compensation: $22.29 hr - $26.74hr.
Saint Anthony Hospital is a diverse and community-centric organization your career can thrive in, while addressing the health and wellness challenges that families in our neighborhood face. Our employees deliver on our mission and achieve success by working together to provide excellent customer service and patient care.
As part of Saint Anthony Hospital's commitment to providing the highest quality health care, we will be building a new state-of-the-art hospital to serve as an anchor to the Focal Point Community Campus. Learn more at focalpointchicago.org.
Position Purpose:
Insurance Verification & Eligibility
• Verify insurance eligibility and benefits for all assigned inpatient and observation accounts.
• Re-verify insurance coverage when patients transition into a new calendar month to ensure continued eligibility and prevent billing denials.
• Review and update insurance information accurately within Meditech Expanse.
• Identify discrepancies in coverage, subscriber information, coordination of benefits, or registration data.
• Review payer requirements for inpatient admissions, observation stays, and specialty services.
Authorization Management
• Obtain, review, document, and track prior authorizations and inpatient notifications as required by payers.
• Monitor authorization status throughout the patient's stay and ensure extensions or updates are obtained timely.
• Communicate authorization concerns, delays, or denials to appropriate departments promptly.
• Maintain accurate authorization documentation within Meditech Expanse.
Account Review & Error Identification
• Missing or incorrect insurance information
• Conduct daily account audits to identify
• Coverage termination issues
• Authorization deficiencies
• Registration inaccuracies
• Incorrect patient class or financial data
• Report identified workflow or registration errors to direct leadership for corrective action and process improvement.
• Escalate high-risk accounts that may impact reimbursement or patient care.
Collaboration & Communication
• Work collaboratively with:
• Registration
• Financial Counseling
• Case Management
• Utilization Review
• Nursing Units
• Patient Financial Services
• Provide timely updates regarding insurance or authorization barriers impacting patient care or reimbursement.
• Assist departments with payer requirement clarification and insurance-related questions.
Documentation & Compliance
• Maintain complete, accurate, and timely documentation within Meditech Expanse.
• Ensure compliance with hospital policies, payer regulations, HIPAA guidelines, and departmental workflows.
• Meet productivity and quality standards established by leadership.
• Performs other duties as requested by Manager/Supervisor.
Requirements
This position requires a rotating schedule, including rotating weekdays, weekends, and holidays as assigned.
• Rotational coverage is necessary to ensure continuous monitoring of:
• New month insurance eligibility changes
• Inpatient authorization updates
• Observation stay reviews
• Time-sensitive payer requirements
• Flexibility to support departmental operational needs is required.
• Ability to communicate effectively & timely
• Ability to work closely with other departments to ensure timely reimbursement
• One or more years of insurance verification experience.
• High school diploma or equivalent.
Benefits
Comprehensive health insurance plans (medical, dental, vision)
Coverage begins first day of employment
Employer-matched retirement plans
Eligibility for the Public Service Loan Forgiveness (PSLF) Program
Free on-site parking
Why Join Saint Anthony Hospital
Community-Focused, Technology-Driven: Work in a setting that combines advanced technology with a mission-driven, community-centered approach.
Competitive Compensation: Receive a strong, market-aligned salary package.
Innovative Environment: Be part of an exciting transformation as we transition to a new, next-generation healthcare campus.
Collaborative Culture: Join a close-knit team that values communication, teamwork, and mutual support.
Professional Growth: Grow your career in an organization that invests in development and continuous learning.
Meaningful Impact: Serve a diverse patient population and make a real difference in their healthcare journey.
Recognition & Excellence: Proudly recognized as a Primary Stroke Center and a respected teaching hospital shaping future healthcare professionals.
EQUAL OPPORTUNITY
Saint Anthony Hospital is an affirmative action/equal opportunity employer and does not discriminate in hiring or employment based on age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation, or any other protected status.