Skip navigation
Unable to save this job. Please try again later.


Email this Job to Yourself or a Friend

To begin the application process, please enter your email address.

Company Contact Info

  • Palos Park, IL 60464

Already have an account?

Sign in to apply with your saved resumes.

New to CareerBuilder?

Don't have an account? Continue as a guest!

Sorry, we cannot save or unsave this job right now.

Report this Job

Trust and Site Security Team.

Email Send Failed!

Managed Care Specialist

Heart Care Centers of Illinois • Palos Park, IL

Posted 29 days ago

Job Snapshot

Travel - None
Experience - At least 2 year(s)
Degree - High School
Competitive Pay and Benefits
Healthcare - Health Services, Managed Care
Health Care, Insurance
Relocation - No


How Do You Compare to the Competition?

Get facts about other applicants with a CareerBuilder Account

Job Description

Heart Care Centers of Illinois, a multi-site network of cardiovascular providers, currently has an opening for an Insurance Specialist / Managed Care Specialist at their Palos Park, IL location.  As part of a small team, the Managed Care/Insurance Specialist will be responsible for the overall processing of insurance verifications, referral/pre-certification/pre-determination requests and managed care contracts received via phone call, in person, and/or per request of physician/nurse and other HCCI staff.  Our ideal candidate will possess excellent customer service and time management skills, with the ability to prioritize a demanding work load.


Additional responsibilities include:


  • Prioritizes and processes incoming Insurance Verifications, Referrals, and Prior Authorization requests
  • Refers authorization requests that require clinical judgment to Prior Authorization Supervisor
  • Verifies member/patient eligibility and enters information into IDX
  • Supports Prior Authorization and Referral Clinicians
  • Ensures insurance carrier documentation requirements are met and referral support documentation is filed in patient records
  • Identifies and informs callers of network providers, services, and available member benefits
  • Informs providers of patient service decisions
  • Coordinates with members, providers and key departments to promote an understanding of Prior Authorization, Referral, and Insurance Verification requirements and processes
  • Maintains general understanding of application sections of evidence of coverage, handbooks, etc.

Job Requirements

  • 2+ years experience working with Insurance Verification, Insurance Authorizations, or Specialist Referrals
  • Experience with Health Plan Utilization/Insurance Claims departments required
  • Knowledge of Government Payor Regulation, Compliance Policies, Medical Terminology and Coding preferred
  • MS Excel skills required
  • High School Diploma required, Associate’s degree preferred


Heart Care Centers of Illinois offers a competitive salary, excellent benefits package, and a weekday only schedule.  If interested, please e-mail resume with salary requirements to [Click Here to Email Your Resumé].  Apply today!

Help us improve CareerBuilder by providing feedback about this job: Report this Job.
For your privacy and protection, when applying to a job online, never give your social security number to a prospective employer, provide credit card or bank account information, or perform any sort of monetary transaction. Learn more.
By applying to a job using CareerBuilder you are agreeing to comply with and be subject to the CareerBuilder Terms and Conditions for use of our website. To use our website, you must agree with the Terms and Conditions and both meet and comply with their provisions.