Healthcare Authorization Specialist - Insurance & Pre-Certs

Cooper University Health Care; Camden (NJ); On-site; USD 29,000 - 45,000; Full time

Job summary

Cooper Norcross Health is seeking an Insurance Verification Specialist to verify eligibility and plan benefits for inpatient and outpatient services. You will work with payors, coordinate benefits, and obtain pre-authorizations, pre-certifications, and referrals.

Proficiency with IDX Flowcast, Imagecast and EMR systems is preferred. Based in Camden, NJ, this full-time, on-site role offers a fast-paced environment with high-volume calls and opportunities to support patient access and financial

Qualifications

• Verifies insurance eligibility and plan benefits.
• Contacts patients with inactive insurance coverage to obtain updated information.
• Validates coordination of benefits between insurance carriers.
• Explains insurance plan coverage and benefits to patients, as necessary.
• Secures insurance authorizations and pre-certs for patient services both internal and external to Cooper.
• Creates referrals for patients having a Cooper PCP. Contacts external PCPs to obtain referrals for patients scheduled with Cooper providers.
• Refers patients with less than 100% coverage to Financial Screening Navigators.
• Identifies copayment, deductible and co-insurance information.
• Collects and processes patient liability payments prior to service.

Responsibilities

• Verifies insurance eligibility and plan benefits.
• Contacts patients with inactive insurance coverage to obtain updated information.
• Validates coordination of benefits between insurance carriers.
• Explains insurance plan coverage and benefits to patients, as necessary.
• Secures insurance authorizations and pre-certs for patient services both internal and external to Cooper.
• Creates referrals for patients having a Cooper PCP. Contacts external PCPs to obtain referrals for patients scheduled with Cooper providers.
• Refers patients with less than 100% coverage to Financial Screening Navigators.
• Identifies copayment, deductible and co-insurance information.
• Collects and processes patient liability payments prior to service.

Skills

Insurance verification

Hospital/physician office experience

Payor online portals

NaviNet/Passport

EMR systems (EPIC)

High-volume call center

Education

High School Diploma or equivalent

Tools

IDX Flowcast

Imagecast

EPIC EMR

NaviNet

Passport

Job description

Cooper Norcross Health is seeking an Insurance Verification Specialist to verify eligibility and plan benefits for inpatient and outpatient services. You will work with payors, coordinate benefits, and obtain pre-authorizations, pre-certifications, and referrals.

Proficiency with IDX Flowcast, Imagecast and EMR systems is preferred. Based in Camden, NJ, this full-time, on-site role offers a fast-paced environment with high-volume calls and opportunities to support patient access and financial