Care Coordination Pro: Transitions & Payer Navigation

Hackensack Meridian Health; Holmdel Township (NJ); On-site; USD 26,000 - 37,000; Full time

Benefits offered by this job

Health insurance

Retirement benefits

Tuition reimbursement

Paid leave

Job summary

Hackensack Meridian Health is seeking a Care Coordination Specialist to perform utilization management, insurance authorizations, and referral management within our care coordination team. You will support scheduling and documentation in EPIC and related systems.

Ideal candidates have a high school diploma, healthcare experience, strong communication and time management skills, and the ability to work independently and as part of a team in a fast-paced hospital setting in New Jersey.

Qualifications

• High school diploma or GED; experience in healthcare preferred.
• Effective written, oral, and interpersonal communications.
• Proficient computer skills; able to learn EPIC and INDICIA.
• Excellent time management and ability to work independently and in a team.

Responsibilities

• Payer communications - responds to requests and inquiries and provides information as requested.
• Prepares required Appeals and Denial information for processing and follows up on receipt of communication including Livanta appeal management process.
• Providing patients with the IM Letter from Medicare prior to discharge.
• Reviews daily admission data for insurance coverage, pre-certs, authorized days, and alerts to potential problems.
• Contacts insurance companies for benefit coverage and obtains authorizations when needed.
• Manages Referrals to external facilities and services and handles referral documentation.
• Arrange Medicaid appointments and follow-up appointments at MD's offices/clinics.
• Adheres to HMH competencies and contributes to team objectives.

Skills

Written and verbal communication

Interpersonal skills

Time management

Teamwork

Self-motivated

Experience in healthcare

Education

High School diploma or GED

Tools

EPIC

INDICIA

Excel

Job description

Hackensack Meridian Health is seeking a Care Coordination Specialist to perform utilization management, insurance authorizations, and referral management within our care coordination team. You will support scheduling and documentation in EPIC and related systems.

Ideal candidates have a high school diploma, healthcare experience, strong communication and time management skills, and the ability to work independently and as part of a team in a fast-paced hospital setting in New Jersey.