Authorization Specialist
2 weeks ago
We are a leading healthcare provider in South Jersey, committed to delivering exceptional patient care and innovative medical services. Our team of dedicated professionals is passionate about making a difference in the lives of our patients and their families.
As a key member of our team, you will play a vital role in ensuring the smooth operation of our financial clearance processes. Your expertise will be essential in verifying insurance eligibility, coordinating benefits, and securing authorizations for patient services.
Key Responsibilities
Some of your key responsibilities will include:
- Verifying insurance eligibility and plan benefits
- Contacting patients with inactive insurance coverage to obtain updated information
- Validating coordination of benefits between insurance carriers
- Explaining insurance plan coverage and benefits to patients
- Securing insurance authorizations and pre-certs for patient services
- Creating referrals for patients with Cooper PCPs
- Referring patients with less than 100% coverage to Financial Screening Navigators
- Identifying copayment, deductible, and co-insurance information
- Collecting and processing patient liability payments prior to service
You will also be responsible for providing clear and concise documentation in our systems and communicating daily with insurance companies, internal customers, providers, and patients.
Requirements
To be successful in this role, you will need:
- 2 years of experience in insurance verification or registration in a hospital or physician office
- Working knowledge of medical insurance plans and products, coordination of benefits guidelines, and requirements for authorizations, pre-certifications, and referrals
- Proficiency in working with payor online portals, as well as NaviNet, Passport, or other third-party eligibility systems
- Experience working in a high-volume call center
- Proficiency in IDX Flowcast, Imagecast, and EPIC EMR systems
Education Requirements
A High School Diploma or equivalent is required.
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