Authorization Specialist

3 weeks ago


Camden, New Jersey, United States Cooper University Health Care Full time
About Us

At Cooper University Health Care, we strive to provide exceptional healthcare services to our patients. Our team of professionals is dedicated to delivering high-quality care, and we are committed to providing a supportive and inclusive work environment. Our employees are our greatest asset, and we offer a comprehensive benefits package, competitive compensation, and opportunities for professional growth and development.

Job Summary

The Authorization Specialist - Insurance Clearance Expert will be responsible for verifying insurance eligibility and plan benefits, contacting patients with inactive insurance coverage to obtain updated information, and validating coordination of benefits between insurance carriers. This role will also involve explaining insurance plan coverage and benefits to patients, securing insurance authorizations and pre-certifications, and creating referrals for patients with Cooper PCPs. The ideal candidate will have a working knowledge of medical insurance plans and products, coordination of benefits guidelines, and requirements for authorizations, pre-certifications, and referrals.

Responsibilities

* Verify insurance eligibility and plan benefits
* Contact patients with inactive insurance coverage to obtain updated information
* Validate coordination of benefits between insurance carriers
* Explain insurance plan coverage and benefits to patients
* Secure insurance authorizations and pre-certifications
* Create referrals for patients with Cooper PCPs

Requirements

* 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

* High School Diploma or equivalent

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