Member Certification Specialist jobs in Illinois
Member Certification Specialist coordinates the certification and credentialing programs of a professional or membership organization. Participates in the development of standards and the creation of testing materials. Being a Member Certification Specialist maintains and monitors a test scheduling system or database. Organizes resources to implement testing schedules and sessions, including locations, testers, technology, and materials. Additionally, Member Certification Specialist assists members with information about programs and resolves any issues with the process. Interfaces with and monitors outside testing providers. May require a bachelor's degree. Typically reports to a manager. The Member Certification Specialist occasionally directed in several aspects of the work. Gaining exposure to some of the complex tasks within the job function. To be a Member Certification Specialist typically requires 2-4 years of related experience. (Copyright 2024 Salary.com)
Recently Added Member Certification Specialist jobs
Pre-Certification Specialist
- Insight
-
Chicago, IL
FULL_TIME
-
WE ARE INSIGHT:
At Insight Hospital and Medical Center Chicago, we believe there is a better way to provide quality healthcare while achieving health equity. Our Chicago location looks forward to working closely with our neighbors and residents, to build a full-service community hospital in the Bronzeville area of Chicago; creating a comprehensive plan to increase services and meet community needs. With a growing team that is dedicated to delivering world-class service to everyone we meet, it is our mission to deliver the most compassionate, loving, expert, and impactful care in the world to our patients. Be a part of the Insight Chicago team that provides PATIENT CARE SECOND TO NONE! If you would like to be a part of our future team, please apply now!
General Summary:
The Pre-Certification Specialist is responsible for processing referrals for services and obtaining needed authorizations from the patient’s payor source. This is to be done for both out-patient testing, out-patient surgeries and inpatient stays. A Pre-Certification Specialist is responsible for collecting all information needed, to properly notify and obtain authorizations from all of the patient’s payor sources and be able to effectively communicate.
These duties are to be performed in a highly confidential manner, in accordance with the mission, values and behaviors of Mercy Hospital and Medical Center. Employees are further expected to provide a high quality of care, service, and kindness toward all patients, staff, physicians, volunteers and guests.
Duties and Responsibilities:- Contacts insurance companies and other payors to notify of admissions
- Obtains and clarifies procedural and diagnosis information form physician
- Identifies correct insurance plan and contacts the patient to determine if secondary insurance coverage exists.
- Receives and processes requests for internal transfers for confirmation of patient benefits and notification of patient status change
- Verifies insurance coverage and benefits for patient admissions either electronically or via other media
- Makes written and/or verbal inquiries to third party payers to verify insurance status and obtain pre-certification
- Refers patients to financial counselors to assist with payment for services
- Creates patient pre-registration accounts in the electronic system to allow for the addition of notes to an account
- Keep orderly files of information that is gathered
- Distribute information to appropriate departments to expedite patient care
- Performs various clerical tasks to expedite the verification process, including documentation of guarantor information, patient information and protocols
- Analyze reports to determine changes in patient types
- Perform other duties as assigned
Required Knowledge, Skills, and Abilities:- High School Diploma required
- Must have 2 years of college in general business field or technical school related to medical field or a experience equivalent to the above
- Must have previous customer service experience or education
- Ability to provide excellent customer service at all times
- Ablitiy to mult-task
- Understands medical terminology
- Understands insurance terminology
- Understands Medicare, Medicaid, and commercial insurance
- Previous experience with data entry computer system
- Ability to organized an systematic
Insight Employees are required to be vaccinated for COVID-19 as a condition of employment, subject to accommodation for medical or sincerely held religious beliefs.
Insight is an equal opportunity employer and values workplace diversity!
- 11 Days Ago
QA PRODUCT CERTIFICATION SPECIALIST
- NOW Foods Branding
-
BLOOMINGDALE, IL
FULL_TIME
- ESSENTIAL DUTIES AND RESPONSIBILITIES may include the following. Other duties may be assigned. Advises R&D and brand managers on various product certification standards, including organic and bioengin...
- 1 Month Ago
QA PRODUCT CERTIFICATION SPECIALIST
- NOW HEALTH GROUP, INC.
-
Bloomingdale, IL
FULL_TIME
- ESSENTIAL DUTIES AND RESPONSIBILITIES may include the following. Other duties may be assigned. Advises R&D and brand managers on various product certification standards, including organic and bioengin...
- 1 Month Ago
Re-certification Specialist
- SHP Management Corp
-
Chicago, IL
OTHER
- $1,000 sign on bonus!Re-certification SpecialistDuties/Responsibilities:• Conduct file reviews for compliance with the applicable subsidy type (S8, LIHTC, etc.).• Prepares reports that summarizes item...
- 1 Month Ago
AHA BLS CPR Instructor
- Certification Classes LLC
-
Ridge, IL
CONTRACTOR,PART_TIME
- Earn $45.00 to $85.00 per hour teaching 2-3 CPR classes per week part-time with additional pay available. Flexible hours. We offer daytime, evening and weekend classes nationwide. Join our fast-growin...
- 10 Days Ago
CPR BLS Instructor
- Certification Classes LLC
-
Ridge, IL
PART_TIME,CONTRACTOR
- Earn up to $50.00 to $130.00 per day teaching 2-3 CPR classes per week, part-time with additional pay available. Flexible schedule. We offer daytime, evening and weekend classes. Join our fast-growing...
- 10 Days Ago
Member Certification Specialist jobs at Popular Companies
Radiology Pre-Certification Specialist
- Billings Clinic
-
Billings, MT
- Youll want to join Billings Clinic for our outstanding quality of care, exciting environment, interesting cases from a v...
- 4/20/2024 12:00:00 AM
Pre-Certification Specialist -- CAMC G.I. -- Chesterfield Bldg- 2
- CAMC Health System
-
Charleston, WV
- Job Summary To ensure procurement of accurate pre-certification authorization/referral for applicable returning and new ...
- 4/20/2024 12:00:00 AM
Inside Sales - Government Contract and Certification Specialist
- Government Services Exchange
-
Clearwater, FL
- Job Description Job Description Inside Sales – Government Contract and Certification Specialist Government Services Exch...
- 4/19/2024 12:00:00 AM
WIC Certification Specialist (WI0807 - Potranco)
- Communicaresa
-
San Antonio, TX
- ** WIC Certification Specialist (WI0807 - Potranco)** **Job Category****:** Tech **Requisition Number****:** WICCE002683...
- 4/18/2024 12:00:00 AM
HCV Certification Specialist
- Steuben Churchpeople Against Arbor Housing & Dev
-
Corning, NY
- Job Description Job Description Description: Assist low-income families and individuals, who may include homeless, elder...
- 4/17/2024 12:00:00 AM
Long Term Temporary Position Certification Specialist
- Travaux Inc.
-
Milwaukee, WI
- Job Description Job Description CLASS SUMMARY: This position is responsible for performing technical and support tasks r...
- 4/17/2024 12:00:00 AM
Regulatory Certification Specialist 23-00850
- ESPO Corporation
-
Arlington Heights, IL
- Title: Regulatory Certification Specialist Location: Arlington Heights, IL Duration: Permanent Hire Reports to: Engineer...
- 4/16/2024 12:00:00 AM
Senior Housing Assistant Rental Specialist - Certification Specialist
- Division 10 Personnel
-
Milwaukee, WI
- Job Description Job Description Code: 2121 Location: Milwaukee, WI Job Description: Senior Housing Assistant Rental Spec...
- 4/16/2024 12:00:00 AM
About Illinois
Illinois (/ˌɪlɪˈnɔɪ/ (listen) IL-ih-NOY) is a state in the Midwestern and Great Lakes region of the United States. It has the fifth largest gross domestic product (GDP),
the sixth largest population, and the 25th largest land area of all U.S. states. Illinois is often noted as a microcosm of the entire United States. With Chicago in northeastern Illinois, small industrial cities and immense agricultural productivity in the north and center of the state, and natural resources such as coal, timber, and petroleum in the south, Illinois has a diverse economic base, and is a major transportation hu...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Member Certification Specialist jobs
$72,220 to $111,821
Most Popular Cities in Illinois for Member Certification Specialist Jobs
What does a Member Certification Specialist do?
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