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Medical Insurance Specialist

1 month ago

Elizabeth, New Jersey, United States RWJBarnabas Health Full time
Job Summary

We are seeking a highly organized and detail-oriented Medical Insurance Specialist to join our team at RWJBarnabas Health. As a key member of our healthcare team, you will be responsible for ensuring accurate and timely insurance verification and authorization for our patients.

Key Responsibilities
  • Verify patient insurance information and update records as necessary
  • Contact insurance companies to obtain current benefit information and eligibility
  • Obtain initial authorization and precertification services from managed care companies
  • Document and data entry on all managed care/EAP cases, including information on payor status forms and timely entry into a computer database
  • Track and manage case activity for the entire treatment process, ensuring all services are authorized and backed up with related documentation
  • Coordinate with clinicians and physicians to obtain clinical data for continuing case review and facilitate timely completion and submission of forms to managed care companies
  • Provide statistics on managed care/commercial insurance cases on a regular basis
  • Prepare out-of-network agreements for patients with special billing arrangements and track service activity utilization
  • Assist with managing charity care caseload, as assigned
  • Provide verbal updates on the overall status of managed care caseload to the program director/designee, as requested
  • Provide information and referral services to patients, as requested
Requirements
  • High School Diploma required and one year of related experience required
  • Managed Care and Insurance experience required
  • Passport software experience preferred
Benefits

At RWJBarnabas Health, we offer a comprehensive benefits package, including paid time off, medical and prescription drug insurance, dental and vision insurance, retirement plans, short and long-term disability, life and accidental death insurance, tuition reimbursement, health care/dependent care flexible spending accounts, wellness programs, and voluntary benefits.