• Job Description

  Req#: 5001020364606

  Job Description

  POSITION SUMMARY

  AtlantiCare Physician Health Network is currently seeking an Insurance Verification Specialist. In this role you will be responsible for obtaining verification of all insurance benefits for patients and maintains/enters that information to reflect the most up-to-date coverage. Your duties may also involve obtaining pre-authorization for services, which requires effective phone communication skills. After verifying coverage, you will determine benefit level coverages and patient financial responsibility. Bilingual communication skills are a major plus. Attention to detail is key. This role requires the use of Cerner/Oracle revenue cycle and practice management modules and various additional applications.

  • Verify insurance eligibility for patients and referrals by using various verification tools/apps or contacting the insurance carrier directly
  • Update insurance/benefit information for existing patients
  • Review schedules for upcoming patient appointments
  • Enter new demographics into Cerner
  • Review patient copays/deductibles and enter into the Cerner
  • Coordinate with front end regarding registration/eligibility errors
  • Enter insurance, referrals, authorizations and other related patient information into Cerner
  • Answers questions from patients, physician practice staff and insurance companies
  • Obtain pre-authorization for recommended services and procedures
  • Determine and communicate patient financial responsibilities
  • Communicate and help resolve eligibility and authorization related denials
  • Manage worklists and queues and eligibility rejection reports
  • Participate in educational activities and attends monthly staff meetings
  • Assists in the development of communication and processes to improve overall departmental performance

  QUALIFICATIONS

  EDUCATION: High school diploma or GED certificate

  LICENSE/CERTIFICATION:

  EXPERIENCE: 1-2 years of relevant experience preferred; medical billing experience (preferred). General knowledge of CPT codes and basic medical terminology (preferred). Requires extensive computer/application use, phone communication skills and comfort with significant computer use and Bilingual ability (English/Spanish) preferred.

  WORK ENVIRONMENT

  Potential for exposure to blood borne pathogens along with infectious diseases. (Refers to Blood Bourne Pathogen requirement)

  Essential functions of this position are listed on the Assessment and Evaluation Tool.

  REPORTING RELATIONSHIP

  The above statement reflect the general details considered necessary to describe the principle functions of the job as identified and shall not be considered as a detailed description of all work requirements that may be inherent in the position.

  Location(s)

  Cape May Court House

  Job Category

  Finance

  Hours Per Week

  37.50

  Weekends Required?

  No

  Holidays Required?

  No

  Department

  AIM - CMCH

• About the company

  The AtlantiCare Regional Medical Center Mainland Campus is a 323-bed hospital, opened in 1975, and located in the Pomona section of Galloway Township, New Jersey, United States.

Notice