Lead Authorization Special - Cooper University Hospital

About Us:

At Cooper University Health Care, our commitment to providing extraordinary health care begins with our team. Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies and research protocols. We have a commitment to our employees by providing competitive rates and compensation, a comprehensive employee benefits programs, attractive working conditions, and the chance to build and explore a career opportunity by offering professional development.

 

Discover why Cooper University Health Care is the employer of choice in South Jersey.

Short Description:

Acts in lead position to other Insurance Specialists ABS, coordinating daily work assignments and facilitating resolution of any problem accounts or issues. 

 

Trains new employees on Insurance Specialist job functions, policies, procedures, tools and systems. 

 

Prepares training and reference materials and keeps all information current.

 

Performs all duties of Insurance Specialist ABS, including but not limited to the following:

• 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.   

Experience Required:

3-5 years insurance verification or registration experience in a hospital or physician office.

 

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

 

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

 

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

Education Requirements:

High school diploma required.  Bachelor’s degree preferred.

Special Requirements:

Excellent verbal and written communication skills.

 

Detail oriented; ability to multi-task using multiple information systems.

 

Working knowledge of medical diagnoses and procedural codes.

 

Proficiency in use of MS Office Word, Excel, Outlook, Access and Power Point.

 

Ability to organize, take independent action and project Cooper values to customers and co-workers.