Medical Authorization Specialist - Fast-Paced Hospital Support

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

Job summary

Cooper University Health Care in Camden, NJ, seeks an Insurance Verification Specialist to verify eligibility, benefits, and referrals before services are rendered. You will coordinate benefits, obtain authorizations, and create referrals for patients with Cooper PCPs, ensuring accurate billing and pre-certifications.

Ideal candidates have 2+ years in hospital-based insurance verification, call-center experience, and proficiency with IDX Flowcast, NaviNet, Passport, and EPIC EMR.

Qualifications

• Verifies insurance eligibility and plan benefits.
• Contacts patients with inactive insurance coverage to obtain updated insurance 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 insurance 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

Coordination of benefits

Pre-certifications

Referral processing

NaviNet / Passport

EPIC EMR

IDX Flowcast

Call center experience

Microsoft Office

Education

High School Diploma or equivalent

Tools

NaviNet

Passport

EPIC EMR

IDX Flowcast

Imagecast

Job description

Cooper University Health Care in Camden, NJ, seeks an Insurance Verification Specialist to verify eligibility, benefits, and referrals before services are rendered. You will coordinate benefits, obtain authorizations, and create referrals for patients with Cooper PCPs, ensuring accurate billing and pre-certifications.

Ideal candidates have 2+ years in hospital-based insurance verification, call-center experience, and proficiency with IDX Flowcast, NaviNet, Passport, and EPIC EMR.