Reimbursement Specialist: Verify Coverage & Authorizations

VNA Health Group; Tinton Falls (NJ); On-site; USD 22,041 - 33,062; Full time

Job summary

VNA Health Group is seeking a Clinical Reimbursement Specialist to verify insurance coverage, obtain authorizations, and relay third‑party reimbursement information to ensure accurate coverage and timely payments. The role requires detail orientation and collaboration with internal teams.

You will support payer communications, maintain reimbursement resources, and monitor service quality while upholding the organization’s mission to deliver patient‑centered care.

Qualifications

• High School Diploma/GED required; Associates degree preferred
• Must have prior experience working with managed care and workman’s compensation carriers
• Knowledge of third party reimbursement required
• Strong computer skills
• Excellent written and verbal communication skills
• Excellent interpersonal and organizational skills

Responsibilities

• Supports organization’s mission by striving for excellence in all aspects of the job with a focus on positive interpersonal relationship with co-workers
• Assures accurate and timely verification of reimbursement information to ensure coverage of insurance
• Assure authorization (if required by payer) is obtained in a timely manner
• Perform payer coverage duties as assigned
• Assists in designing, implementing and maintain a manual of insurance resource information in collaboration with the Manager of Clinical Reimbursement
• Establishes and maintains positive working relationship and communication with external and internal groups
• Monitors quality and appropriateness of services and processes
• Other duties as assigned
• Adheres to the organization’s policy in regards to absenteeism and appearance

Skills

Managed care experience

Workman's comp experience

Reimbursement knowledge

Computer skills

Written and verbal communication

Interpersonal and organizational

Education

High School Diploma/GED

Associates degree preferred

Job description

VNA Health Group is seeking a Clinical Reimbursement Specialist to verify insurance coverage, obtain authorizations, and relay third‑party reimbursement information to ensure accurate coverage and timely payments. The role requires detail orientation and collaboration with internal teams.

You will support payer communications, maintain reimbursement resources, and monitor service quality while upholding the organization’s mission to deliver patient‑centered care.