Job Title: Insurance Management Specialist
Location: Morristown NJ 07960
Contract: 06+ months (possibility to extend)
Shift: 8am–4pm
Pay: $26-$28/hr on W2
Duties:
Communication
- Function as a liaison between external Insurance Companies and internal staff to ensure patient needs are met.
- Notify internal staff when patient updates are required.
- Communicates with CAC & Clinical Teams to ensure required financial information is available to review with patient.
- Communicate with Clinical Teams to request necessary information for ongoing authorizations in a timely manner.
Insurance Verification
- Verifies patient insurance for all incoming referrals for all payers.
- Verifies patient insurance during course of episode if payer change occurs or a need for re-verification arises.
- Participates in the re-verification at designated times of year, i.e. open enrollment period.
- Documents all verification information in EPIC to ensure CAC, clinical teams and other departments are aware of results.
Authorization
- Understands and enters pending authorization as required.
- Demonstrated knowledge of payors and required documentation for precertification and authorization.
- Obtains timely authorization for ongoing authorizations for home care and hospice services from select payers online, by telephone or fax per company requirements.
- Documents all authorization information in Epic to ensure clinical communication, as well as accurate system notification of ongoing needed authorization
- Request and /or submit clinical documentation for authorization/reauthorization in Epic, prepares updates as indicated.
Department Workflow
- Ensures coverage of department for assigned hours of operations.
- Manages assigned patient, insurance and/or acct EPIC work queues, ensuring accurate and timely completion.
- Participates as directed by Supervisor of Verification/Authorization in the EVV process.
Skills:
Knowledge/ Experience with obtaining authorizations, familiar with insurance verifications preferred.
Education:
High school diploma or GED.
#SJ
Pay: $26.00 - $28.00 per hour
Work Location: In person
