Senior Insurance Clearance Representative

Advocate Aurora Health

. Acquire and maintain current knowledge of payor requirements, Federal and State regulations, authorizations, and hospital billing .

Posted 9/17/2026full-timeRemote • United StatesSenior💰 $23 - $34 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in insurance authorization processes, including knowledge of payor requirements and Federal and State regulations. Proficient in patient registration, eligibility verification, and effective communication with patients regarding financial responsibilities.

Highest-signal resume keywords

Insurance AuthorizationPatient RegistrationKnowledge of Payor RequirementsEffective CommunicationProblem Solving

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Clinical Data AnalysisProcedure CodingMedical TerminologyMathematical AptitudeComputer Data Entry

Soft Skills

Critical ThinkingOrganizational SkillsVerbal CommunicationWritten Communication

Tools & Technologies

ADT SystemComputer Software Programs

Industry Keywords

HIPAA ComplianceHealth CareInsurance IndustryPatient ConfidentialityUtilization Management

About the role

Key responsibilities & impact

Acquire and maintain current knowledge of payor requirements, Federal and State regulations, authorizations, and hospital billing
Perform insurance authorization for inpatient and outpatient services by collecting and analyzing clinical data according to payor guidelines
Determine appropriate procedure codes for authorization to ensure appropriate reimbursement
Consult with patients and departments regarding uninsured status, uncovered services, out-of-network status, Third Party Liability, and Workers Compensation
Communicate with patients when authorization is not obtained and explain potential financial responsibility
Verify eligibility and authorization using stand-alone computer software programs
Identify and notify Primary Care Physicians for HMO coverage
Identify at-risk balances related to Medicaid eligibility rules and communicate with Financial Counseling, Utilization Management, and physicians
Complete cancellations and accurately reschedule patients
Manage incoming and outgoing calls to complete patient pre-registration
Pre-register and register patients using established computer-entry procedures
Enter accurate patient demographic and insurance information in the ADT system
Generate and process required registration documents and educate patients about required signatures
Participate in staff meetings, continuing education, mandatory in-services, safety training, skill competencies, and group projects
Answer or appropriately refer patient, visitor, and employee questions
Maintain patient-record confidentiality by following HIPAA and compliance policies

Requirements

What you’ll need

High School Graduate
Typically requires 2 years of experience in health care, insurance industry, call center, or customer service setting
Licensure, Registration, and/or Certification Required: None Required
Ability to problem solve in a high profile and high stress area
Ability to prioritize and organize workload
Mathematical aptitude, effective communication, and critical thinking skills
Understanding of basic human anatomy and medical terminology
Excellent verbal and written communication skills
General computer knowledge
Must be able to sit most of the workday
May include intermittent light travel
Ability to operate all equipment necessary to perform the job

Benefits

Comp & perks

Benefits Eligible
Premium pay such as shift, on call, and more based on a teammate's job
Incentive pay for select positions
Opportunity for annual increases based on performance
Paid Time Off programs
Medical, dental, vision, life, and Short- and Long-Term Disability benefits
Flexible Spending Accounts for eligible health care and dependent care expenses
Adoption assistance and paid parental leave
Defined contribution retirement plans with employer match
Other financial wellness programs
Educational Assistance Program