Insurance Analyst Jobs in Illinois

ABOUT ABBVIE

AbbVie's mission is to discover and deliver innovative medicines and solutions that solve serious health issues today and address the medical challenges of tomorrow. We strive to have a remarkable impact on people's lives across several key therapeutic areas including immunology, oncology and neuroscience - and products and services in our Allergan Aesthetics portfolio.

JOB DESCRIPTION

The Supervisor, Insurance Analyst provides leadership, support, and supervision for the Insurance Analyst team. This individual is a subject matter expert on commercial pharmacy, major medical, and government insurance plans, prior authorizations, appeals, and alternate coverage referrals. The supervisor ensures that all day-to-day activities of the team operate smoothly and seamlessly to provide the best customer experience for physician offices and ultimately patients. This position is responsible for ensuring all performance metrics, workload deliverables, and customer services activities are completed in alignment with a high touch business model.

Responsibilities

- Supervise and oversee insurance analysts responsible for verifying new patient insurance benefits and handling claim rejections. Work proactively with staff and cross-functional groups to develop creative solutions to challenging patient access issues regarding prior authorization and denied coverage requests to ensure patient care.
- Partner with Leads to monitor work flow and adjust workload and staffing requirements to ensure that all activities are addressed in a timely and efficient manner.
- Monitor calls and perform case reviews to ensure accuracy of information, adherence to policies, and excellent customer service. Provide additional coaching and training to individuals as needed. Meet regularly with direct reports to provide direct feedback on their performance and progress against goals. Responsible for writing and communicating performance reviews.
- Perform administrative tasks such as work hour scheduling, attendance monitoring and counseling, vacation request scheduling, and overtime scheduling. Participate in the hiring process and handle all employee issues for their direct reports.
- Use effective coaching and management techniques to maintain a highly motivated and interactive work staff.
- Meet or exceed department standards relative to performance metrics. Take responsibility and accountability for the day-to-day execution of tasks and is responsible for providing periodic progress reports on goals and metrics. Provide activity metrics, status updates, and local payor intelligence information to management per established guidelines. Elevate issues as appropriate.
- Consistently build and maintain collaborative relationships cross-functionally to ensure a seamless customer experience for patients and physicians.
- Identify process improvements to increase operational efficiencies and develop action plan for execution. Assist with the implementation of new projects and products within the Pharmacy.
- Understand and comply with all required training, including adherence to applicable federal, state, and local pharmacy laws, HIPAA and privacy policies and guidelines, and the policies and procedures of the business.
- Perform additional tasks, activities, and projects as deemed necessary by management.

QUALIFICATIONS

- Bachelor’s degree or Associate Degree in health sciences or business preferred. Comparable or relevant experience will be considered.
- 3-5 years of experience in the healthcare industry with knowledge in reimbursement, billing, prior authorization, appeals, and specialty pharmacy operations.
- 1-2 years supervisory experience in a call center, large physician, managed care, or healthcare insurance setting desired.
- Demonstrated strong, accurate technical skills. Must be detail oriented. Must have a thorough understanding and knowledge of commercial and government pharmacy and medical insurance programs, billing, alternate funding resources, reimbursement processes, prior authorization and appeal filings, and specialty pharmacy operations.
- Proven leadership and coaching skills. Demonstrated ability to lead and participate within a team, manage multiple priorities and meet associated timelines while maintaining accuracy.
- Must have professional written and verbal communication skills to interact with and build and maintain relationships with all levels of the organization. Must maintain a positive service image at all times even when dealing with challenging issues and unsatisfied customers.
- Proven organizational, time management, and problem solving skills, elevating to management when appropriate.
- Skilled with the use of the Microsoft Office suite and the ability to use and effectively learn and navigate other computer systems.

ADDITIONAL INFORMATION

Applicable only to applicants applying to a position in any location with pay disclosure requirements under state or local law:
- The compensation range described below is the range of possible base pay compensation that the Company believes in good faith it will pay for this role at the time of this posting based on the job grade for this position. Individual compensation paid within this range will depend on many factors including geographic location, and we may ultimately pay more or less than the posted range. This range may be modified in the future.
- We offer a comprehensive package of benefits including paid time off (vacation, holidays, sick), medical/dental/vision insurance and 401(k) to eligible employees.
- This job is eligible to participate in our short-term incentive programs.

Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, incentive, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole and absolute discretion unless and until paid and may be modified at the Company’s sole and absolute discretion, consistent with applicable law.

AbbVie is an equal opportunity employer and is committed to operating with integrity, driving innovation, transforming lives and serving our community. Equal Opportunity Employer/Veterans/Disabled.

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