Insurance Specialist

7 days ago

CAMDEN, United States Cooper University Health Care Full time
About us

At Cooper University Health Care, our commitment to providing extraordinary health care begins with our team. Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies and research protocols. We have a commitment to its employees by providing competitive rates and compensation, a comprehensive employee benefits programs, attractive working conditions, and the chance to build and explore a career opportunity by offering professional development.

Discover why Cooper University Health Care is the employer of choice in South Jersey


Short Description

 

     Acts in supervisory position to Insurance Specialists which support the surgical schedulers and 
     centralized revenue cycle/access management functions for Surgical Services Institute. Working to screen 
     and/or financially clear all patients for hospital and ambulatory surgeries/visits prior to date of service.

     Coordinates the daily activities of staff, ensuring equitable distribution of work.

     Trains new employees on job functions, policies, procedures, tools and systems.

     Prepares training and reference materials, and keeps all information current.

     Maintain workflows, conducts QA audits, and provides monthly updates to Revenue Cycle Director, Admin Director and Institute Leaders:

     Performs all duties of Insurance Specialists, including by not limited to the following:

• Verifies insurance eligibility, plan benefits, and coordination of benefits.
• Obtains referrals and insurance pre-certifications/prior-authorizations for inpatient and outpatient surgeries, procedures, treatments and/or radiology studies.

• Explains insurance plan coverage and benefits to patients, as necessary.
• Navigates and completes referrals for all uninsured and underinsured patients.
• Generates patient liability estimates and provides to patients.
• Collects patient liability payments and/or establishes payment arrangements


Experience Required

3-5 years’ experience preferred in healthcare revenue cycle, with working knowledge of insurance benefits, referral and authorization requirements, billing procedures/systems and codes, as well as alternative funding sources for uninsured or underinsured patients.

Experience with EPIC, IDX Flowcast, ImageCast, NaviNet, AIM, eviCore, Med Solutions, NIA, United Health Care Online, I-Exchange, Encoder Pro, Data Online, Health Quest, and Passport systems preferred.

Ability to organize, multi-task, delegate, and take independent action while projecting Cooper values to patients, customers and co-workers.

Basic knowledge of medical terminology, continuity of care protocols, and coding principles.

Prior supervisory experience preferred.


Education Requirements

HS diploma required. Bachelors preferred


Special Requirements

Strong communication, organizational and interpersonal skills.

Detail oriented; ability to multi-task using multiple information systems.

Proficiency in use of MS Office Word, Excel, and PowerPoint

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