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AUTHORIZATION SPECIALIST
3 months ago
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
Financially clears scheduled inpatient and outpatient services, including office visits, testing, diagnostic studies, surgeries and procedures, prior to date of service. Financial clearance process encompasses any or all of the following job functions:
• Verifies insurance eligibility and plan benefits.
• Contacts patients with inactive insurance coverage to obtain updated insurance information
• Validates coordination of benefits between insurance carriers.
• Explains insurance plan coverage and benefits to patients, as necessary.
• Secures insurance authorizations and pre-certs for patient services both internal and external to Cooper.
• Creates referrals for patients having a Cooper PCP. Contacts external PCPs to obtain referrals for patients scheduled with Cooper providers.
• Refers patients with less than 100% coverage to Financial Screening Navigators.
• Identifies copayment, deductible and co-insurance information.
• Collects and processes patient liability payments prior to service.
Provides clear and concise documentation in systems. Communicates daily with insurance companies, internal customers, providers and patients.
Experience Required
2 years insurance verification or registration experience in a hospital or physician office preferred.
Working knowledge of medical insurance plans & products, coordination of benefits guidelines, and requirements for authorizations, pre-certifications and referrals preferred.
Proficiency in working with payor on-line portals, as well as NaviNet, Passport or other third-party eligibility systems preferred. Experience working in a high-volume call center preferred.
Proficiency in IDX Flowcast, Imagecast, and EPIC EMR systems preferred.
Education Requirements
High School Diploma or equivalent.
