Insurance Authorization Coordinator

2 weeks ago


Camden New Jersey, United States Cooper University Hospital Full time

About Us:
At Cooper University Health Care, we prioritize exceptional health care through our dedicated team.

Our remarkable professionals are consistently advancing clinical innovations and improving access to the latest facilities, equipment, technologies, and research protocols.

We are committed to our employees by offering competitive compensation, a comprehensive benefits package, favorable working conditions, and opportunities for career growth through professional development.

Discover why Cooper University Health Care is recognized as a leading employer in South Jersey.

Position Overview:


Responsible for ensuring financial clearance for scheduled inpatient and outpatient services, including office visits, diagnostic tests, surgeries, and procedures, prior to the service date.

The financial clearance process includes the following key responsibilities:

Key Responsibilities:

  • Verifies patient insurance eligibility and benefit details.
  • Contacts patients with outdated insurance information to gather updated coverage details.
  • Confirms coordination of benefits among various insurance providers.
  • Provides explanations of insurance plan coverage and benefits to patients as needed.
  • Obtains necessary insurance authorizations and pre-certifications for patient services, both within and outside of Cooper.
  • Generates referrals for patients with a Cooper primary care provider and communicates with external providers to secure referrals for patients scheduled with Cooper specialists.
  • Directs patients with insufficient coverage to Financial Screening Navigators for assistance.
  • Identifies patient financial responsibilities, including copayments, deductibles, and coinsurance amounts.
  • Collects and processes patient payments prior to service delivery.
Ensures accurate and thorough documentation in relevant systems. Engages in daily communication with insurance companies, internal stakeholders, healthcare providers, and patients.

Qualifications:
Minimum of 2 years of experience in insurance verification or registration within a healthcare setting is preferred.

Familiarity with medical insurance plans, coordination of benefits guidelines, and requirements for authorizations, pre-certifications, and referrals is essential.

Experience with payer online portals, as well as systems such as NaviNet, Passport, or other third-party eligibility platforms is required. Experience in a high-volume, inbound call center environment is preferred.

Proficiency in IDX Flowcast, Image Cast, and EPIC EMR systems is advantageous.

Educational Background:
A High School Diploma is required.

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