Insurance Management Specialist, Atlantic Visiting Nurse
- Employer
- Atlantic Health System
- Location
- Morristown, NJ
- Closing date
- Dec 10, 2022
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Overview:
Atlantic Visiting Nurse, part of Atlantic Health System, is seeking a full-time Insurance Management Specialist to work Monday-Friday, 8AM-4PM.
Responsibilities:
Essential Job Functions: Performs review of service requests for completeness of information, collection, and acquisition of structured clinical data from our Car Access Center (CAC).Handles screening for pre-certification requests from Epic WQ.Obtain authorization from home care services from select payers online, by telephone or fax per company requirements.Acts as a liaison between the clinicians and the Utilization Review/Medical Management departments at insurance companies.Enter pending authorizations into Epic.Prepare updates on patient condition with appropriate recommendations to ensure authorizations.Function as a liaison between external Case Managers/Insurance Companies and internal staff.Notify internal staff when patient updates are required.Request and/or submit clinical documentation for authorization/reauthorization in Epic.Work with the Billing Department in obtaining retro authorizations with denials and appeals from insurance companies.Performs other duties as needed.
Qualifications:
Education:High School Diploma or equivalent education requiredCollege degree preferred Relevant Experience:Experience with obtaining authorizations preferredFamiliarity with insurance verifications preferred Hours:Full-time: flexible between 8:00am and 5:00pm, Monday through Friday (no weekends)
About Us:
Atlantic Health System aims to deliver the highest quality, safety and care combined with the best experience for our patients and their families. We are confident that you will find success within Atlantic Health System, which has been named for the 14th year in a row to Fortune's "Top 100 Best U.S. Companies to Work For" list. We believe you will find that our culture of collaboration and care exemplifies the value we place on our patients, their families, and our employees.
EEO Statement:
Atlantic Health System, Inc. is an equal employment opportunity employer and federal contractor or subcontractor and, therefore, abides by applicable laws to protect applicants and employees from discrimination in hiring, promotion, discharge, pay, fringe benefits, job training, classification, referral, and other aspects of employment. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, gender identity or expression, sexual or affectional orientation, national origin or nationality, citizenship status, disability, age, genetics, protected veteran status, ancestry, marital status.
Atlantic Visiting Nurse, part of Atlantic Health System, is seeking a full-time Insurance Management Specialist to work Monday-Friday, 8AM-4PM.
Responsibilities:
Essential Job Functions: Performs review of service requests for completeness of information, collection, and acquisition of structured clinical data from our Car Access Center (CAC).Handles screening for pre-certification requests from Epic WQ.Obtain authorization from home care services from select payers online, by telephone or fax per company requirements.Acts as a liaison between the clinicians and the Utilization Review/Medical Management departments at insurance companies.Enter pending authorizations into Epic.Prepare updates on patient condition with appropriate recommendations to ensure authorizations.Function as a liaison between external Case Managers/Insurance Companies and internal staff.Notify internal staff when patient updates are required.Request and/or submit clinical documentation for authorization/reauthorization in Epic.Work with the Billing Department in obtaining retro authorizations with denials and appeals from insurance companies.Performs other duties as needed.
Qualifications:
Education:High School Diploma or equivalent education requiredCollege degree preferred Relevant Experience:Experience with obtaining authorizations preferredFamiliarity with insurance verifications preferred Hours:Full-time: flexible between 8:00am and 5:00pm, Monday through Friday (no weekends)
About Us:
Atlantic Health System aims to deliver the highest quality, safety and care combined with the best experience for our patients and their families. We are confident that you will find success within Atlantic Health System, which has been named for the 14th year in a row to Fortune's "Top 100 Best U.S. Companies to Work For" list. We believe you will find that our culture of collaboration and care exemplifies the value we place on our patients, their families, and our employees.
EEO Statement:
Atlantic Health System, Inc. is an equal employment opportunity employer and federal contractor or subcontractor and, therefore, abides by applicable laws to protect applicants and employees from discrimination in hiring, promotion, discharge, pay, fringe benefits, job training, classification, referral, and other aspects of employment. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, gender identity or expression, sexual or affectional orientation, national origin or nationality, citizenship status, disability, age, genetics, protected veteran status, ancestry, marital status.
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