Insurance Mgmt Specialist I: Full Time, Atlantic Rehab Morristown

Overview:

Atlantic Health is seeking a detail-oriented and knowledgeable Insurance Specialist to join our healthcare team. The ideal candidate has a strong background in healthcare insurance processes, excellent communication skills, and a commitment to accuracy and patient care. This position is vital to assisting both patient and staff, ensuring a smooth insurance process throughout the duration of treatment.

Duties & Responsibilities: 

• 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.
• Communicate with Clinical Teams to request necessary information for ongoing authorizations in a timely manner.
• 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.
• Obtains timely initial precertification and authorization for initial services when required.
• Understands and enters pending authorization as required.
• Demonstrates 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.
• Reviews additional service request for completeness of information, accuracy and presence of required clinical data.
• Request and /or submit clinical documentation for authorization/reauthorization in Epic, prepares updates as indicated.
• Manages assigned patient, insurance and/or acct EPIC work queues, ensuring accurate and timely completion.
• Participates as needed in the follow-up and correction of insurance and/or authorization information, including the process required for payer changes, or obtaining retro authorization.
• Adheres to department workflows

Required:

High School Diploma or GED

Preferred:

EPIC experience

Minimum two years of insurance verification experience

At Atlantic Health System, our promise to our communities is; Anyone who enters one of our facilities, will receive the highest quality care delivered at the right time, at the right place, and at the right cost. This commitment is also echoed in the respect, development and opportunities we give to our more than 20,000 team members. Headquartered in Morristown, New Jersey, we are one of the leading non-profit health care systems in the nation. Our facilities and sites of care include:

• Morristown Medical Center, Morristown, NJ
• Overlook Medical Center, Summit, NJ
• Newton Medical Center, Newton, NJ
• Chilton Medical Center, Pompton Plains, NJ
• Hackettstown Medical Center, Hackettstown, NJ
• Goryeb Children's Hospital, Morristown, NJ
• CentraState Healthcare System, Freehold, NJ
• Atlantic Home Care and Hospice
• Atlantic Mobile Health
• Atlantic Rehabilitation

We also have more than 900 community-based healthcare providers affiliated through Atlantic Medical Group. Atlantic Accountable Care Organization is one of the largest ACOs in the nation, and we are a member of AllSpire Health Partners.

We have received awards and recognition for  the services we have provided to our patients, team members and communities. Below are just a few of our accolades:

• 100 Best Companies to Work For ® and FORTUNE® magazine for 15 years 
• Best Places to Work in Healthcare - Modern Healthcare
• 150 Top Places to work in Healthcare - Becker's Healthcare
• 100 Accountable Care Organizations to Know - Becker's Hospital Review
• Best Employers for Workers over 50 - AARP
• Gold-Level "Well Workplace": Wellness Council of America (WELCOA)
• One of the 100 Best Workplaces for “Millennials” Great Place to Work® and FORTUNE® magazine
• One of the 20 Best Workplaces in Health Care: Great Place to Work® and FORTUNE® magazine
• Official Health Care Partner of the New York Jets
• NJ Sustainable Business 

Morristown Medical Center is a nationally-recognized leader in cardiology and heart surgery, orthopedics, gynecology,  geriatrics, gastroenterology and GI surgery, pulmonology and lung surgery, and