What are the responsibilities and job description for the AUTHORIZATION SPECIALIST position at Cooper University Health Care?
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 to provide competitive rates and compensation programs. Cooper offers full and part-time employees a comprehensive benefits program, including health, dental, vision, life, disability, and retirement. We also provide attractive working conditions and opportunities for career growth through professional development.
Discover why Cooper University Health Care is the employer of choice in South Jersey.
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.
Experience 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.
- Proficiency in working with payor on-line portals, as well as NaviNet, Passport or other third-party eligibility systems required. Experience working in a high volume, inbound call center preferred.
- Proficiency in IDX Flow cast, Image Cast, and EPIC EMR systems preferred.
Education Requirements
- High School Diploma required.
