INSURANCE SPECIALIST-ABS

US-NJ-CAMDEN
Job ID
38715
Category
Clerical
Shift
1
Type
Full Time
Department Name
ABS Admin 100 Federal Street

Short Description

Financially clears scheduled inpatient and outpatient services, including office visits, testing, diagnostic studies, surgeries and procedures, prior to date of service. Financial clearance process encompasses any or all of the following job functions:

 

  • 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.  

 

Provides clear and concise documentation in systems.

 

Communicates daily with insurance companies, internal customers, providers and patients.

 

Special Requirements

 

Scheduled Days / Hours: Monday through Friday

 

High School Diploma required.

 

2 years insurance verification or registration experience in a hospital or physician office preferred.

 

Working knowledge of medical insurance plans & products, coordination of benefits guidelines, and requirements for authorizations, pre-certifications and referrals preferred.

 

Proficiency in working with payor on-line portals, as well as NaviNet, Passport or other third party eligibility systems preferred.

 

Proficiency in IDX Flowcast, Imagecast, and EPIC EMR systems preferred.

 

Skilled in use of computers and software applications, i.e., Microsoft Word, Excel, Outlook, Access, registration and billing systems.

 

Basic knowledge of medical diagnoses and procedural codes

 

Excellent verbal and written communications skills

 

Ability to organize, take independent action and project Cooper values to customers and

coworkers.

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